Death Certificate - Davis, Albert W_7/7/1999RECORD OF DEATH � �
GIBSO\ COU\TY DEPART�fENT OF HEAL'I'H
PRI\CETOV, L�DIA\A
THIS IS TO CER'PIFY, that our records shoK� ALBERT I?. DAVIS died
Seot. 23, 1957 ar 4•30 A M Tdirth Ost=ooathic Hosoital�0akland Citv. Tn
month dey ymr hour oC death stree[, hospital, rural •
AgeatDeath 63 $ex''�d1E ColorFlhlYa \IariCalStatus �t-rriPµTtew�hechermamedorsingle
yeazs
primary cause of dearli gi�•en µ�as Carcinona Head Pancr a ( � r 1 n+etaatat; �
to Small Intestine Diabetes ri�i�; ,�G
Signed by H A Peters D O nakl ancl l'i tv _ 7n
physician or coroner address
Placeofburialorremova I.O.O.F. Francisco, In.
name of cemeten� address
Date of burial �eptamber 25, 1987
Funeral D'vector
SEAI.
Colvin Funeral Ho:ne, Inc. Princeton, In.
address
Signed ��������-• ����
Gibson County Health C missioner
Oakland Citv, In. Sentember 29,1987
eddress date
Recorded locally in book h`o. 11 Page \'0 4 h Filed GPDf- *nh r�9 1 9P7