Death Certificate - Cook, Ezekiel_4/18/1983iusCUftD OF PEATH
0
GIBSON COUNTY DEF'AR'I7vIENT OF HrALTH
PRINCETON, INDIANA' � -
THI;i 1S TO CERTIFY, that our records ehow E2EKIEL COOK d��
3/27/83 ,,, 3:SOPM
month day year hour of desLh etrnet, hoepitd, rurnl �'
Age at Death 62 SPx M• Color Black M�},gl Statue M.
yea=s wrlte whether mnrried or eingl��
Primary cause of death given was M�n�a.-�l;at failure
Signed by Glenn O. Dickenson, DO _ Owensville, Ind.
• .phymeian or coroner � . address
Place of burial or removal Sand Hill Princeton, Ind. -
name of eemetery addrese
Date of burial 3/30/83 Colvin _Princeton, Ind. _
� �nerxl Director addrena � •
� ���'Lr � , �,b �
SEAL : Signed �
Gibeon County Health Comm�en�oner
Oakland City, Ind. 4/12/83
• . . � . , ndarena date
Recorded locally in book No.— 10 � page �No. $ 8 .�Sled : 4/ 9/ 8 3