Death Certificate - Geick, Jean T_7/29/1980RECORD OF DEATH •
•
GIbSON COtiNTY DEPART\1ENT OF HEALTH
PRINCETON, INDIAN�1
THIS IS TO CERTIFY, that our records sho�v �AN T. GEICK
7/26/t�0 at 12:03AM 20� N. Main Ft. Branch, Ind.
month day year hour of desth street, hospital, rural
Age at Death 63 Sex Fe' Color �' llarital Status Widowed
years �vrite �rhether man•ied or single
Primary cause of death given was Probable renal failure, secondary to Carcinoma
Signed by Quentin B Emer�on Mn Ft. Rranr �h• Tn�7,
physician or coroner addmss
Place of burial or removal
Walnut Hill Ft. Branch, Ind.
name of cemetery address
Date of burial 7�28�8� Stodghill Ft. Branch Ind.
F�neral Director address
, � .
SEAL Signe �/ �
Gibson Cou ty Health Commis ' er
Oakland City, Ind. 7/29/80
address date
Reconled ]ocally in Uook No. 10 page Aro. 17 F'iled: �29�80 _