Death Certificate - Cox, William R_2/17/1969� � .� .. - �1 �. . .
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^ RECORD OF DEATH
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GIBSON COUNTY DLPARTMENT OP' I3�ALTI�I
PRINCETON, INDIANA
'' " THIS IS TO C�I�TIPY, th:it our recm•ds show WILLIAM R. COX ����
% 2/19/1969 ,i� 11:40PM Enroute to hospital near Mackey, Ind.
month day year hour of dcath sCrcet, hospilal, ivral
,: Age at Death 9� Sea M• Color wh• Marital Status Married
years write whether marricd or einglc
Primnry cnuse of death given was Broken neck
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. Signed Uy Robert D. Kendall, Coroner Princeton, Ind.
phyeician or coroncr address
;:'„�; Place of burial or removal 5�.. John's Buckskin, Ind.
� � nnme of cemetcry address
Date of burial 2/18/69 Lamb Oakland City, Ind.
� �neral Director address
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: ;;';. SEAL
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Signed
Gibson County Acalth Commissioner
Oakland City, Ind. 7/3/84
addreas
Recorded ]ocally in boolc No. H-50 page No. 109 Filed
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2/17/69
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