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Death Certificate - Chance, Carl C_12/1/1976-.,. �.,, v. ,•r;` ., � e:�'�., , , _ 4. : .�' ;'; �. .�'�e�' .� �. . � ,� .. �. a - • -. . �."u'.`:�.�a...G:.s�.�, ..� ...,.::�. ._>.._._�..____. . .:......_i..d� .....(�....��_ :..ad..:`... . ' +-.. � . .. . .. .. .. . n _. ... � _._ . . � . ... . , . . _ . . l ..� .. . . . .. _ . .r .. . . .. . •. ' RECOIiD OI' DLATH * ' , ' . � . . ' . . . '�� GIBSON COUNTY ll�PARTIViLNT, Or H�AL'PII ' �� ' , .PRINCETON,INDIANA . ' . �' TIIIS IS'1'O CI�RTIP'Y, tViat oui:records sliow CARL C. CHAD'CF..; died 11/21/19'J5 at1��ilAM Gib. Gen. Hosp. Prinr,eton, Ird. month day ye5r' ' .' 'hour of dcath _ � strr,et, hospital, rural , ' • � Marr1Q�1 Age at Deatl� '� 7� Se c' °_Ma1e Color l� PMtlrital St<ttUS ; µ.rite whether married or single ycars . � , ` � � � � • Cancer of lune Primary causc of death given was . . JamPS F '�Ppck M.D• Princeton,� -;y� z .."I •�i. � A i ,, I�' - . ,' ,i,s: �.. - �... , Signed by • . , i - ,�� ' pl�yqician or coroner . � address � Place of burial or removal ;' St. JnsePh P.rLnC°��11.�n�1- �' � . address i name of cemctery - �� . i i llate of bw•ial 11/?4%�6 • ' Colvin 3c Son Princeton Tn�7 � � � � Puneral Director . - .address I ^��, � � .� ,. . •. � . � � ��q/ //G�:`/J, .Ci (n(�� /�N I • � • � . ' . . .. � (� j' / . , �J �. / � .' SEAL .. , '- - . . ' Signed ' � . _ � . � � Gibson Com�ty Health Commissioner , f„ . : . j� . . . �, ,. Oakland Cit,y�, Ind. 11/89/7� .. ' . � . . . . . . . . address . � " ' '. :! � ' - date y .' . . , . .. , . • . , . I :`,.,. `.' il/?4/7h . � ,', �; Recorded' lo�ally in book No''' 9. T'age No__3�—F�led: : , . , -' _ . - . _ j t: J . . . � . .� ` . � . .. ' - � - ' ..... _�.. ..�. .. ..� � . . n.�..., . . .. .. . •. . . .. u � k � L y 1