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Death Certificate - Donelson, Clyde L_4/13/1987RECORD OF DEATH �
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GIBSON COUNTY DEPART�IE\'T OF HEALTH
PRIVCETON, I\DIA\A
THIS IS TO CERTIFY, that our records show CLYDE L. DONELSON died
Feb. 10, 1976 e� 12:45 A.M. Gibson General Hospital Princeton, In.
month day year hour ot death street, hospital, rural
Age at Death � 6 Sex Male ColorSVhite tiqarital Status Married
years write whether married or single
Primary cause of death given was Myocardial Infarction ( 1 Hr. ) Hemmorrhaqe
from duodenal ulcer.
Signedby James F. Peck, M.D. Princeton, In.
physician or coroner eddress
Placeofburialorremoval �ite Church Princeton, In.
name o( cemetery address
Dateofburial February 12, 1976 Colvin and Son Princeton, In.
Funeral Dvector address
SEAL
Signed "�l��i��96��.ti
Gibson Countv Heal[h C issioner
Oakland City, In. April 13, 1987
aaa�ess deu
Recorded locally in book No. 9 Page \oZ 1 Filed: February 13 , 1976