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Death Certificate - Gibbs, Leonidas_2/24/1956� �o` ii b� v M. � _ r _ Cr . � . _ . . �c-, )�- e 1�� A.' x �_ 1; 1 y6 J i �� n� n � ..�_ �`� Ff..1U J% � A., i�,l K � �� _ dy �� A! k C . � J�{ ' � �o�. ¢��� � n}1 .'� 1 p �i� �� I du . f d ti� eE `_ � n� { � k` r �9 �°• . i ia a � N .-. '+' ; It 'I = iY ... � �E �Y � �f'� R - ��' �, LO�:AL � ^ ��- i 'ii.: of . t� 'L�11: � 'r;� i�' ',i IM �nn � �n � �'� i i :H� '�� �,� �_'i RECORD OR�DE4TH � � ^ ° _ r ` ^ � = • " I� r � �� � I! � < < �t' ir �, - 1 "� ' ti _ � �r r � � � �i 4 ��e _ � .j!r � Q . 1 ` ' w - ` ' , � �_ ' lG '" � = 4, r,; � r�- , , � . � A�.. r h . F . r �, . = x + � 7C CITY DEPART?�1ENT OF HEALTH � ` ;� � " �� �° ° • � � � u�.�� G -OL,PRIVCETOri INDI�IZ�A '�A '"� � �i �� ` : w ' � '` v = ) I[c �� .l� � _ p . � � ..ny � . �_tl p � Cy 9t� � � � �� ". ��o h- Y r.. � �_ .�; N �. J: �5. �� M w .d �_ � 1 9� �. . v� �, � . 1 � _�, M1 1 � -L_ �� � . ,'y fq • �rl rr � - ° f i . i m i 7 Da ° L ��l � THI'fS IS TO CERTIFY;;that onr records show ��c����i -. y` � � died �, _L � 1 � '�' d p . � .�� � 1 ' 11 M � II � N �. v Y t- �� .i} � � �1' � - .. T 1 . _ _ I' ' 1 f � �� o r v� �� :1 r _ b i y� �i _ . . 1 � � _ � .s� G; at3aOP71Ja� a'E ��'��f�°�.� Q' �` '� �imonth`; +�-+�+ day ��:�� �i�� year M��.' p� hourof death���� "� :� �� street�-hosppiptalarural �IG�-�_ y � �0 PI<g il�' � l� Ni �- 4� �'��- �I�l � 1 ` y� . Fn � ' � � !� . •�k "I .-� � �y � Ifl ° .f� - tl �- u� � "�: ��� �` i - L � 1 : ,Y� �� � " � 'f� iq4 I � 1P h ,�� � V �viY/� A) �%A� � eh� B . r � � Age at deat Se . p YColor _ ,-� --� �� ' � i .',� � '��� 9ears= �� 41 = i .� b .;t�1 U�` ''i �{I ;n«r�te whether married ox smgle " "` � '� i._ �pp q ¢ ��r X u �, , f q n° � �� �� h i� �` r n �� �o �„ � i�� � �0�.� nL "� - � � }�� i ['!� �l Xd �7r - r��� w� � . L 1� � a : ti Prunary cause of death given «as a�- -^�`' A�- ��-.-� ,��� e� P6 „'' ���_ �^ �9 '�_, � . ( � � ,�aJ- e t V u .0� e� I, U� ) ,.1 ! i�'� �� � � � P �� d 8,� ,o� ,K 6�� -� �a r� rt� ..C'i_'h,•lt� AL�� f ��;iG..!K � �lQ. �,���.�'�l>���t� - ..aF.p,e��o�ac d: ��� ;3� �L.. .��e ,��Oe. �� il _,�Y�' C ry� lc r' r��l� 1��'y �- I^ �� f� _ -.. � ..� �i'' '.I � i 4 ���// �� � �/ /i. � 7 . � � p � f . ��� ' ti. � � � i � Y � � L i.` i y Signed �by _� � � � t %7.' � 1� _ i = � � � � ' ..,bo kr ` '. �� 'Id � ' + physcian��or c � er' � C� i �� . f � �y� - :t 0 r1 -address�. � ' t {�; - - � � .�{;' !d � ni�;, 1�'LP.'.�� �Ic =',�� ri � � hV iC �� t�.x �na, ��` ti�� MY � d �.�io�f � G�-'� � - � Place-of burial� or�removal ���9` �� t� � ! �� � � � � i��� "� ��` � G 1. - � � ` " �'W� ��� �.of cemetery �.� = h„ ��.� i �� ` ` iaddress . � ° / `.� �� �.�,� ��, � ��, � ��- M: P �� ��� t � ��� q �li � �'� al �_�� P �) � III T� M � �.^ .n � O�a���{`��� °�� M�' a� �d n� l� h. h , Date'of burtaL�._.�_^3 �' � ° ' � y � °` r .r' , _'^ i �� -Jt �0.:'_ , J � ' . .i a � . r .. ��.. £nneral D�mctor r � 7 �� �• address C� � ' I 1� � h 1�`�� A _ lfy� p N`t'� + �d "� a ifi p� ,� `, y� -,'7� 1 �Q' �fi, I i �'= SE�.L�u- � �i� � '� �`� y � '��' Signed ��� c ��- ' ��z�-�FC .a Secy.. ��•.� � �� -�� ���� � p � �j � .�� �����f� � ���� h �-pf��� U°c ��,Y� �F' ��i�� ��� �N� r � Y��� � ,'1i� .�'�i 3 a .. - '�•--�.� �� � � iJ � xt ' /�1�� �� t � ���.. �.:� � J �rd.v � '- - c� . � �. - - o � .�d �� k� �� � :�� ry � , M � . Ni �8 (�i2S5�'- i Y ��. �� J� . � � uf d2fR�� � !. 1j^ . 11 b-S:F K s..� X � A� � '� � b v � �' �) �b_ a .i�. 'YT � 1 ,t � �� II r ��• ' i 7 1 � � .p _ t:, ` Recorded locally in book �No "''�' � � bPage �\To r'� � . I' , � v„ � � � ' ��� �s f ` ' , _ ,, .- ..�r 0i �16�G ai 1 ��.. ��'..if � -i�t� 7��`t'h` h e�'�'�� f A.'�� { y� ..-�d It�- �� �n r� �j�i �� �:� ai' x� . E���; � .� � ,�q A u. 1 P .4 � a .°�1"�-�` � � �tl °� ,� '+� � ���� k �`� - � -� v d.- � .� � �� i! i .� ' 1� L' . c � I � . i �S: t z L ��PU 11� -7 CI iA .�t— i h��1 if H. �� ki Y�. `_ � t' .� . , .� �. ,. p' _. , .e'!e� ..r. .. �C .� ' "'P��" � "'� 1 . �.� - �J I M�,� - , . .�i.�._ �., --rA: � _ .. _ . I.. � . . ,�(