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Death Certificate - Debord, Arvel B_4/6/1976
� � . . • . ..5� . t � RECORD OF DEATH - - _ �. ���;� .- '' : -,x: _ ,' . GIBSO\ COliNTY DEP�IP.T\fENT OF HE�LTH �' t� � ; , . ';� . , , � . . . - .. ' . . PRIVCETON, INDI:IVA ... � ',..�•_' • •. .- " . . � . � " - - �,'� '•. . '�� � THIS IS TO CERTIFl, that our records.s]�o�vL'_��-�-ei �_°U-���'���� '� �'� � d�ed -'+' .i � �� ' r /� � t Si �Y;��7�. { ,`ti u,t. •/=Z .�/�IGbJ --a` �yS�Hiy�_i1�� ,:.:,�;;;'�' ` � 1�.. � � . �� � 'onth dap � pear hour of � death . street,, ho'spital, rmal . .. � � g . y �Jhn,��J ��.t. �J�.�,.�-.c� -;_;. � . A e at Deatli_ � Sez_—____Color___ • : years u•rite u'hether marned or smgle �' �� � ��. ) s , � Primar��'cause of death:,given was--�? ?�=Q-'"��"-� ��,l������ � � s. '•"` �f — , ;! - • � . . . � _--_—___ � �� j j e. � r t.. �, :� :/� ' ". . . ' _ . 1:., _ . . ' .1 � � � � /,(r� � �h / ��7 (� f � . � (� 4 . . .. e -( � � 3. f oC./LG.(t<---� ✓�� (i'�r�.<�� � .�/. � �LCirt-c���'7� .i S�gned by — — � --- o�bZ_o( ��a-.�aJ: . _ . . y�, :^ �. . .-..:�, - T .address � � ,,� . . . - ,� �o . - - n . - . � � i � Place �of burial`^or i emo, nl�t+..''t,.�.-.-�� lz�»v_ , .. •/C_/P., �it-a-ri-c.�.a�e.� :.�K,-e(-<-'o..�..-.�' -t � " - . - na ie of ceme.erp /� addres� ' � • • � � � � � � �' � Date'of burial��/.r=(� � /lenvoCa ee'J. �-�-c.rt�,,.c�L-�-�eJ %t-c-��e-.;.�{'�-�-'•e-:.-al�1.�" '; : - � �. � - ' Funeral Director� - � . — •-r�-. , � ' . . . . addre=s � .,� .�. �Q � ' SEAL , , r . . . � i' . ' Sig-ned_�<-!_P,�-o-,�.J�'1 `LU-u;c:.J +;" > . ' " ' ' � � . - , ^ . GiAson County� Health Commissioner � r � , , �-�-�-.�G �.��� !' S �- LJ y ' j. . _ . . . . ` - . - Li4,(irwc/ biv �.cC,c..sc-,�.v ' �- �' ! �-'�(m s . ' ..j .. • . . � . . address " _ . ��;:':�' date' T.�+; . . �. �^ r � � � � . - � ' �� y,. � : . . ; . '' . . . ; � 4 _ _ . , Recorded locall�-.in book \To. `� So __Page No.-7 7 : . . , ' ;, . . • , • _ .�'- '��; . . .. - � . ... ,. . - . • : , � .. . .. . ' � . , : . � . �C vr..� . . . t,. , . _ . . .• � r ��� �.. _ � .� - � . r. . . �<' '' .t�� ��,ii . ' . . :.` ':Jrt: ... . . ' ' .. . . . ..- . .. . . t . • . . - � �� � � �1 . . . . � .. � _. .. . . ... .. •� ..�f�. ..... ..♦ �.f . � �.. . .�4 . .. ��.