Loading...
Death Certificate - Douglas, John_12/2/19741 � ' 1 ,. _; , RECORD � OF t, ' t„� Ct � f i �. ` S �✓� i:. � THIS,`•IS XTO: , ' ",. ._ .. ��•.� �x. 7�h �:; ; � � ' � • )EA7H �/ •` - �.� � � ��y� :Y:., . '� : ��r �;' `:? GIBSGN COUNTY DEP�TH4EATT OF_;HEAL'iH , t;;;Y: � � � .-� ���. . � � PRINCETON, INDIANA � .. � ` - +j�:s . . . � . . .' ; ". . .. . � ��� . . .a'.'. . ' ._�: :. � . •..I %u'« i+e/�Ty�� �ERTIF'1', :that our records show ~ JOHN' DOUGLAS-'. �t� :;.; �b ' � �., � .s � . . . � ' . �'�?, :' :'e' � .i - ' �. _:. ir-: r g� ��'� �,07i1����._:�_�A�1,9.9KO'�M ' . 1f� . �t':,!`ih�_:Cc�i�i LTncn .l.P�.i.�i:ctnn��`. �S S }+..' ( SCf� - �1tZS „' Pnmary cause `lL"' � •�:.=1t4i'�1rT:l t • r ��. ; -�a S�gned by�k�..�. ; . t ��: �}-i �' r J �. � Place` of bunal �i � : it� +yv Date of bunaL T (j � � 1 S Y 4� t �} S !a � �i �Y ' i i ' v �{ �e � t ���F ,, SEAL'� ` s.� :: � .'�i � � :i� {„� �� i. "' t T . : r', Recorded locall j��; � + : �,.` F�� � _ �t � i . . '. �, . i .�. t - � _ . .. =/:ts;: �:�.;Sex•" C9a��e-' ,,.� Color " vtn�te ..•, n�afltal�Jtatlls yCBis , , � . -. �-� i' 4"i ' r � . f � , ; . ' � . . � � � , . K % � 41-b of death:'giyen waa Cerebral AemorrfiagP �% �� �t � . tr ;-C. n' x ' , ` S/ :i� ' + 7 2 '• �� � -.. - . a -. , 1. � t- i.�G GP1 rk TG 1�'� ° ` ' Ft Branrh T '" _�`pfiysician or coranei- � ''a' _, addressT� , . , . ... ,�. :=`s or rremovaL '�dal n,�t Hi'I 1' ':' F�-.—���,�. r� ��' � � ���� name of cemetery, . � � ' addresa��? s. ' % f -, . ; .��< ,.. � ' • � .. s� �,' . �Y� �,11 �74 � G r oa �hi i i FUS1P�'81 u0i&° '�t "'� r •.� � : Flineial Dimctor . .:` . - '` ` add�ess;• ' } : . _ _ �. � . t . 4 � � . � j . W/;� ;.. , � Y-'� L'f � • �///{� � r �� F , � �, i '�", f/"CG.N ` ' r � • y . . Signed `:- >. ' � � Gibson' Caunty � � � . . . . � , . .�..n ? �'" . =� - - ' Princeton;" � " - � .. addresa ? �= '�� y � - . I - . � � .1'. _ -}' il • .' ,. -' � � .. . ��n, book:,No ' A' �' ':, page No:. 1 D� -.• �led `-1�%� a t4 • , �. t . , t � . c_' „ ' . .. Y :';. �� � i. ' i� � s ;, � -_r 4 . . C' . 4 3U '. i `Y v .. "7 . ,j �5 F-��_ -. ��-�� { r°��. � � S y_ 4�' . ��if '+� � R 'a ' � ��. ��n.: fa .., c s d �:' d c•t F. c . s�. �_. . T� r � Z'�, 4 Y. fIl y . r rtf d vj� . ♦ f{Th-`,,. r��. i �:.;t;.+'` 4 � �.' i�n ., .:.'.t..�«RY.�t' .i-u`'�:_�1�3�..�,��.: �;:RS>r�e ; �i C .�