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Death Certificate - Decker, Ada E_10/31/1972i�i, - �'•�1 c r`:.' '� .s' ' .. . • :' i+~ �.1� �,3j.��t t.`j, .:''. RECORD. OF. DEATH ' - ' . ' . . �. , . • � •,. _ _ ,', . . . � . . - � � � . _ ''='�- � t � , ` GIBSON COUNTY" D1�PART\IE\iT OF HFALTH � �. - i _:'i, : " � � �� PRI\CETO\, I\DIA\�a .. � . �,-'� '- 1 ?:� ' � ! . . � .y ' : _ _ ,j , y.,� ' THIS,IS:TO CERTIFY,`.that �our records sho«.` " -ADA_E._DECKF.R ' - -died ', ,,_ . , , _.. , + � _ � ,.. , . • - . : . _ , . . . . _... . 7� �; (lct 27 - �9-Z2 at 9-� 20AM Gib •.: G"R. -Hos�.—gr-�neeta��Iu�. ` 1mo�tfi � ! day . }ear ., hour of deat�i � stteet hq,pital, rural � , ' h;�'Age at Death-85-:' �Sex- "Fesna.�e-=—Color' � White � .•-Widowed � �" _ . ..`.. � �.. ,<'...years . .. d-rite �chether married+or single . ; , ,� S. .. q: ' , • �., � - i�_ ..,.>,•.''�' a.: ; .i. � :. .' 1 . • ,, ' - , . - ;; - Pnmaty;caase`of death-give�� was ��_'�A�eno-CarcinQm�of_ColorL_ �� • . .. Y � ' �: . ' _7— . . � I. � _ y`'�=t 'y �S � . a . . .. ... . .. � .... � . . s�� ' .� _ - 5.... �. . - +.tj< .. . 1 r , , . .. _� . . � �._ . .t .._�t _ • �.. . .t[ . � . ' '_ Y � �� : . _ _t : ._ .< � r> i �. �; �S�gned �� [4m R:� Wells,_MD ; , -;.Princetoii, Ind. . - ' !� s _ „r..�.�-�r—. - � ph�sivanror coroner� :•;� ..—.. . .- addre s '_..,.r . . �.. �a �,�• , ,.,.. '�,.:.. . � :I.O.O.F :.s�,...�Hazleton Ind�.�� i' :_,,.c>� !' Place of �unal or remova! . r - � �-'? . �+ name of ceme[ery - _ . ad�iress - . " - � . � � ' �. � - ' : . ` . � i - . j� , . . -. - . ." . • { . .. . . _ '"Date of burial '10/7Q'/7�"' �=�' �Z�cin &�or ' �� P`r � ��' ' � " .- :.j_,� - i •,t; Funeral Director - . . - ''. .� .� - • � -i; _SEAL � ' � �S�gne � �%�' ' � � :�_... .r,�. � - ::'v¢.`.•.. .:. ` -' ' ";' • � "� _ . ii'; ' � � �- i . ' � . `- Gibson County �Health Coriiroissioner s . .� . �. r.- _' .... ,., . .... ,. � � . ' � . . ,.. .. . � . y � . . . _ . � .. , ' � � , �";. ._ . .. . ,' 'PLinceton,—Indr _. � �: �`�z jz� . .*S . ' ' . . � " .. . . . � ' address - .-. � . . . , Date - - �t� . - _ .. . . . . _ -,�_.. ' •' �:- :�R�orded�locally'in tiool�,No. ' $ �: � Page ?�o. 6L—Filed:�9_�3Q/]2, . , - . : : s • � ,� ' � i: r . � • - ., . �, ' ��,.- ., . .. . .,. . _ . • . ' ti, '.- c. " �� ' i, �t ,''. . . �. ..: � , ` .+� � t �� .� , � _ .�hiQC. .M�i...__,..�ai.! �...,.e......_..��_ _`"� .1 a.�....++. ,..."_ .' _��-..._��_ . ..__t 2_�1•` ., •