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Death Certificate - DeBord, Bertha_1/31/1966:dOJ�� 1�AdOJ�'' J �_�2'0•�. '`3* { —ca . — _ �'z�Otl3x . .... . - r ' � _- /^' . �-I� s. $. ��,�: f" . � . � � ; ' -_�� _ 4 � � { t :}�i (__:ii;.«:j'."':ito -S• � _! :rr,��;-; —�i .rr.—.ir, .—r�r,--•�s-�. -•�r---rf.s--:'^_— �•�..��'_ :iS ��_�i7';1:' :�i:��+-I}•'-'f.—:i�: "!�`�Si`� :!:_...ii: =tfi._:�t'�.i1.__,�;�.; `�—eY-.^'„��^�'[�:.'_^SI"; 'ff 1� `i G�.}'( ��;1 i' . ' � 1: 1 ° 1� ' � �� • " 1t j li 3 "' �j� " :� �` �_: �� i� !r � It.� .tf:lt�� , � �::�I:-tt� '�� ` . i� � i � . 1 ..il :: '- - �==7i: "i::-- I t � .t � . ��t �� s ��.t . �+ j i " 3. ". i-+.REC�RD �F•DEA�1'H �t ` �f•i` i!'.i.i� t� il �� r��} ',E �3 Et.�,.f'�' �c ;.�� ii.�� {i ��.i�.i�:ii. ��.�"ii'f'I . F 1:.�_i� .,::, � t� 4� i i � ' � .t .Tf[ f = !� ...: . t �� ..�f_.....'�C�!_ _ 1• •tEL � ,� �� (� �^GIBSQ\T COU\TY?DEP-�RT�fE\T OF HEALTH � •� "�i { '�� ' i� `�Jii'i.i . .-'� (� - f 'j .: �( .� ; :-1i � � . ' PRI\CETO\ I\DI4\.a i �E � r . �' � i� � t. � �� .� t-. f � � .Ir.. .!1 • - .it�'it__ f f ��; _'7_ i 7�• IfC •_ J ,�,:;;.�..��.L.� .n. � .€I !`.�i.;-�:: -�,:: .,. �,. ,�..-i.�°t?t:-('�:.. -" l.�_ ��.3i—.�.: �_i � i� . ii 1 � •i:-1i1:'`�,it �� -i) �iV i` iF " , ��' ��'-'�E'-�1'°, , �' � 1 f� � 'i " �'�Txts r T ' t - ! 1� �� /� �, �, —�` ' l�..i j � :.f �� . 0 CERTIFY �that our iecoi�ds sho�y .C� �/>' � { �' f, , ''_'� 2 t. 7 `� ' II �i 11 ii �� j� �2 �-. . .. . . i .- i i � -� � � .'(�10C� � i _S � / i It�, �i }, i �� ` ��/_ �//�' ` 1 2� �ip � te /% ; j �� y r� t rl '�'�'1.',:.�!� t.� . _ lLX_�..�1 � � � � � 3t �''" , � C --� .�=n!�f�.�' -� /�� ; •. 1 .:.j manth � day �� - � .�, � - _-. � i _ � 1' Y j( t{ ^` ' S .l ear ' i< /i. ihour. of dea h " � 1 r �. �t hospital,(�v .T;ff >-' � 1_ 1 1. � ! i I3 ^ 1� 3 1 •I� .�• i t: I.�trT�l z.. F i. F .'i tf� % 'it � .. �I_'. t� < r � 9�e at Death�-Z Se� � �'Goloi� =�; � ,- .ti:._Ft � t�'� . � �!G[��? i'-�• i f i i o ' �,: i I, 1 i.STars �� -�c� f� 4- �. .� . y : i a�nte mhether mamed or�smglei= .- -! �-� .; . �: � � ..r �� f` .�1 �� .i.�.� {i � � _ �� i1 1; '} i. ,T. .' ;j ., ., i� . Pumaiti ca�se of death gieen was � ��Cl�i '! ° i �€ 7! ' ;` t �� n '� i� !_ � i. ;� ?� � s. , :� � �� . �t � � „ .�4 � i.i ;' �� ;; �� ,i��' � �E .� "_ �F '� �� t� t if �� t �E"" t; ...ii.,...� i� �� f _ �1 t�� ' : : F - � � -- _. :} ( .' ._ _ .1 .il�� . .� � t� �� _ i , : � -i � �� . � ]. . � ;:; i- .y i � 1 p F � j_ e ._ _.. t_. ��._' ,- � � . ��. . . '-;�Y ii° � /� � 1 �� ' [ ! ' �/ I� / �� fl =SlgtlOd'bY_:/�. t�ician or cor � r. ��_, ; ! i/./f/% � ' � lLs�4J < < � �i: . � i - 1; � i: {� �� • �; � t: fl i ' .! � � �address ( �,- ' f '}' - �. �� .' c . ,f . l� _.i .. l..a ' 7 � �{ .t s �i �. f � 1� a 7/ .� }� ' �! r t Ij . Pl1ce of bwi11 oi'iemo�al r�� -�°�� ?= i i ' '� !' �: < , , �u�� , � . . u � � : � ;� I+ +}- name cemeterv� � � � � i ; .. t. f� , � � � i , � t - r� f �t �ad ress. . .I t f / �/ ��% > � � / c. j 7 �i �� 4 �Date of bui�aL!•-'�n��j� � k; �; ��`�rrr ��Z�l� �� =� i_! �:ci.�/�'i: �__-t � � i -� i:��' " �-��neral D�rector �� r� ' ° � iN �i ..1 � � � � address . i: i /: �� %^� f�� .t :.�:i�:i�.. +� � � - � t �3 ^ S.Y..��:_: —. � 1 �, i, ��'�� ',��,�/�« �i �� ` � �� +' 4 /s �o / i (� t'il f'� )=�f� ' tae'_L � SEAli �:. .�, , � , , � , e , � � ' -� ��:_ - � i i � � Signed l� � o - - 7 � i� -:Ia�':iry_ -:ti L`, � ' S � _o � � � . . �liF1J�X/' } . f< <� . � ,� ��Y � p� ' . + �S �- ! rt tj � Gibson �County Healch tmm�ssioner ti� {��. "4 . � y i �S _ `- �i. 7 �1'�: t ls� i�3. o.� �5�. � ��F � �t fi e �3 ; ' . ' L'._f �I_'"'f• i ' :!-: ..`.._'3 . �f- �l � � �� i �.:}�3,:}�:°::et`-'i:"aj_=�I;"�1 . t ��/%/lGl�'s��//� � ,G lCGu'"_�/ yj�t�� Y.�t �� y 1_ _(i �'�f .!3 ��:e�',=..j.� ii-Y''fi� i� addre�� _Ii � } �t4 2 (�:_':i��-`�� •Cda�.'�71� � . ,i_ ' f � ` '� � `� si � , � ' i f �r t�. �:—`�i , . , • } ( , f� , , -, / � t, �•0 r, �Si,:.��_ ;� ,;Recoided localh m book \,o: �+• � � •' Paee \ot'�.�_(� � ' r� E � .;y.�i.,�.�1 =E� � �� .i{.�..t��=��f: ! �,:-= t F� �t=�-lE;� �:.'�_t't �! ��'�_�� `•�i ��'i�:_i:�-:ii �.�st'� :.�1. .1i .1. f�.:,.lt�_'�, �i. .�1 =;�._ac�..._ I �;� '� ;�: ^SI ".�; - t!.� - _ - i4.�!`i,';'�i{:��;.t_�::tl: �j'�c -5��='1'j` �11 ..... � !��t[..:i°' + .eE `!�'-!,13=��'='iI]�1j 5= �'`C`_ _i�:_. '.�'f'�...'i� �' f__'�j...._I.i'""_i�C �p i�: �{_{G`i _ iti�i3.� ��._....el. � :3M3':}�`.:t -:t:�t�,.._:it==1'.l�.�i:S: :i�•i)'titi�l.{ :1i ' y..lt`;;'i�,':°'E. ; _�f�... (i�l:.':ii.{ ..f1:.;:�I ^'�i:f i. , � � _ I l�_� , ( h :� � ,,.f� 3 t ,� , s� ��•'.��=�f� � � _„• �.'�4;.' ! � � ___ ��4 ,� ';l�=i!-1i—� ?�'—;! _ ,_�� i!----iE. __�s.�_�� :l�__._i'L . t t(:�If�ir �t = •�•;�-!:,i:y � - -s.�.1.c.��a.i� ^�:,. 1. __i.i.L ..u' _ . � � �`�:"�� - �: . . .; , , � JAN 311966 . . . �� '� . . � AUDITOR G, C- � j .; ' � • ' _ I , ' � � . . � ..