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Death Certificate - Fougnies, Mary E_12/14/1983RECORD OF DEA1'H � ❑ GIBSON COUN'I'Y DEPARTMENT OF HEALTH PRINCETON, I.�IDIANA THIS IS TO CERTIF'Y, that our records show MARY E. FOUGNIES died 12/11/83 at 6:35AM Gib. Gen. Hosp. Princeton, Ind. mont6 day year honr of death �treet, hospital, rural Age at Death 73 Sex Female Color �ahite nqarital Status Widowed years write whether married or single Primary cause of death given was Cardiac arrythmia Signed by Ari,n ('_ x„mar nn n p�j,��y�p���_ physicisn or coroner address Place of burial or removal Fairvi ew T i ntp�,�r�, name of cemeten• address Date of burial 12/13/83 Colvin princ.etnn� rn�1 _ Fi�neral Director address SEAL �/(/ ��".—' ! V`. � e �1,G/ Signed Gibson County Health Commissioner OakIand City, Ind. 12/14/83 address date Recorded locally in book No. 1 � Page No. 10 5 F51ed : 12 / 14 / 8 3