Death Certificate - Davidson, John T_6/9/1994•
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ItECORD OF DEATH
GIBSON COUNTY DEPARTM�NT OF HEALTH
PRINCETON, INDIANA
THIS IS TO CERTIFY, that our records show .T�]��. nnvTnsplv --died
8/24/198� at lOAM RR#1 �azleton, Ind.
month dny year hour of denth etreet, hoepitul, rural
Age at Death 6o Sex__ M' —Color wh' Mnritnl Status. m' _
yeare wrltc whether mm•ried or single
Primary cause of death given was Acute myocardial infaretion
Signed by— Chas•les Hendrix, 1vQ) Vincennes, Ind.
phyeicinn or coroner addrese
Place of burial or removnl navidsQn___R�?#� _�.zleton. IL]�__ _._
nume of cemetery addrees
Date of buriai_�/?2/80 0. D. Harris & Sons Petersbur�, Ind.
FLnernl Director addresa
SEAL
l , i / � 1 ,�ZL G� ( /�i,C/
r�tJ �i
Signed
Gibaon County Health Commfeaioner
Oakland Ci.ty, Ind. 5�4�81
nddress . dnte
Recorded locally in bbok No. 1� Page No. 2� �led: ����"�80
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