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Death Certificate - Gaston, Amelia_8/2/1973x . .. _ .' ' . . '?" ' ✓ . .. ' .. '' i �r - . . . . . .. . . . . . ' . � . , ' . . . c 3;' .... RECORD OF.DEATH GIBSOAT COUATTY DEPARTnSEATT OF HEALTFI - , _ � _ � _ PRINCETON,- IVDIANA � � � - .' � - � . � - �`THIS-IS TO CERTIFY, thaE our records sliow �'Amell'a �Gastom '- � � died M3v 14, 1962 at 2PM Gib. Gen. Hosp. Frinceton, Znd. � month _dap year . . .hour of death � � - street, hospital, rural � � � -� +r� y $ . . . .. . . . . . . ., ;�Age at Death '�K Sex Fe*cale Color White �Iarital Status 1�arr1 Pr? ,, -� years � � - � - . � � write a•hether married or single Primary cause of death given was Mvocardial fa1-1 ,r Signed by Orville M. Graves. nt.n. pripc�� ,� �- ' � physician or cozoner . � - � address . . - . - . - Place of burial or removal ' I• 0• O• F-' Un 11�n ,? �� ' - name .of cemetery � � ' � address . _ � . � - . � . . . . . . . - . . � � . ��. Date of burial 5�1�/62 Colvtn .w .SOn Prin�eton, �nd � � " FuneraY Director . . � � . ' address " . � . _ �..� .. . . . . . . . . , . . � x �� - . � :. . . � -. � . - � . - . ��i"';zS/'"��{��'1��i�!�"' 4 • � � t � ,�2 �;, $EAL . _ . _ . . . � - Signed Gibson County Health Commissioner _ _ �.. �. - - ' � . . . . . , Princeton,- Irid. - 8/2/73 � . �. - .. � - - . address � � , - - � date . Recorded locally,in book I�TO. H-50 'Page No. 7 Filed: 4/? K/�+� ' . . . . . . . . �.. � . � . � . . - n ri ., . . . .. :� . . .. . .. . .- - • _ � . . . . .. �., . . ' . . ' . . . I' �. � � . , � � f , - ,=-