Death Certificate - Cansler, Mary Bessie_11/4/1977RECORD OF DE<�TH
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GIBSOV COUNTI DEPART�fENT OF HEALTH
. PRI\CETO\, I\DIaN�1
THIS IS TO CEFTIFl, that oui• records show �ARY BESSIE CANSI,ER �i�
_ 10/28/77 at 12:30PM Gib. Gen. ;iosp. Princeton, Ind.
month day year hour of dcath street, hospital, rural�
Age at Death__8�} Sex—F�-------Colm.—Vdh_—,lfariud Status---------------PJ1dot•-ed--
� years �crite whether married or singlc
Primar}- cause of dcath gi�-en �tns Uremia
Signed bc Bruce Brink, � D.O. � Princeton, Ind.
� �•' ' �' � ' " phpsician or coro�er � address
Place of.Uurial or removnl' � �Maple Hill Princeton, Ind.
- � '� ' � ' �'���• • � �namebf�cemetera - � � . � " � address
Date of burial 10/30/7% Colvin & Son Princeton, Ind.
Funeral Director- address
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SEAL� Signed i ,'
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Gibson County fiealth Commissioner
Oakland City, Ind. 11,[�/77
. address date
Recarded locall}- in Uook No.—° Page i�TO.�Filed: 11�3�77
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