Death Certificate - Cox, Carl_4/12/1989I2ECORD OP DEATH � _�
GIBSON COU\'T`Y Ui�['A�,TBIE\'T OF IILAL'Pli
. � PRIVC�TOY, INDI2.NA
THIS IS TO C�RTIFl", that our records
�ril
month
: •:
day yeaz
3:20 A.t•1.
hour of dea[h
CO:{
1�_G_;= Jackson_St. pakland CitvJ In.
strcet, hospital, rurat
Age at Death �2 ge� hiale Color_'��.tt.'=,1larital Status_ !`�arried
years a-rite x•hether married or sinblc
Primaiy cause of death gi��en u•as_��cinom�:+_t_:; �( 5 nt_ �„_thG�_ _�IPf'as�a�l�_ __
Carcinomd ( i Year L,-8S1�a��_ars:.u�ma r,f r�,ncr ( � vr�arsl-.--Cara:::ir�-
Artery'Disease. -
Signed by Donald L. Hall,_M.D. _,_.__ n�tr�rsh�_ rn_
phpsician or coroner address .
Place of Uui•ial oi• removal Pleasaant Ridae P�rtes_sl'�___jn_
name of cemetery• address
Dateofburial �pr_1 8, 1986 Corn Oa}:land Cit��,_In.
Ftineral DirectoT address
SE:�L
Signed �i�%r'�fG,°.irla ,��., o6Li,g,�fi,(J ---
Cibson County Hcalth Con}itSissioner
oakland C+_t}�, in, December 17, 193G
addmss _ y11c
Recorded'locall}• in Uool; No.�i Page 1`0. `% Fi�e�; rloril 9, 1986