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Death Certificate - Geick, Raymond G_2/21/1978� ! � � .. _ .: -.� . . � ��•�OCAL CERTIFIED :.' CITY-COUNTY DEPARTMENT OF HEALTH � RECORD OF_DEATH " ` J� . � City of Evamville— Vandtrburg6 Coum� �j �� -' I� , . , . . . . . Evaneville, Indiana 1�1 �o _ � � ��2'� '.:' :: '- �� � � . - � . .. '. - . . _ . �•� - - .� '. � �� . . RAYMOND G . GEICK � �. � ._: �' • � This is to Certify;.that our recordc show_°�-------------------------------------------- .. .. '.- �'!:�''. �`.� � . _:` Aied � " � '•-._--DEC----=-26=----- 1977 : 2:00 A.M . -----:-', ,,_ . Welborn Ba.pfis - --�� � , ------------ 8i----------------- t• " i . • . montE . . day _'___'__"'___p'_""'____"_'_ _'___"" '� ' Sear hour of denth . �tzeec, hm iul or wral � �. '. ' � ..,= 65 '- , Male Wh �- � '.;; `.`';:= . . Age�at death_-: ----- Sex--------- Color-------------------------MdTTled . . .�-. � . . . ' .� ._•,: :. . ,' , y�O ' � wri4 wheiher martied or ain�le � Pneumonia perforated duodenal ulcer:''.~ = �-. �.- ' Primary cause of death given w�as----`----------- . ��� -.�;,-�- - _ , . -------------------------- • ' � ------------------------------------------=-.. • Si ned b' E.• H, Arites :,,. �- €. v ------------------- __City --------------� -------------'-- • ; . �_ . ' � ohnidm ]�pQy�p{ . . : i _ "_'_"______"_'___' � . , . . . . . �odrm -__'___' . '' ' Walnut Hill Ft.Branch Ir.d. ` � � ` ' PlaEe of 6urial or removal____________ .�; � --------------------- � : � ----- ------------- .rarm " -. . ' _ name of cemeter� , -----------=--� Date of bu ' 12—Z9—�� Sto�hill Ft.Branch, Ind. ��- -- ----------- ------------ ---------- -------- ----------------------------------1-,-. '. '..',�. _. .� Fn/ . � Signed.,_`,-- ��n� /�/�. -- . a.m _ a - -------- �-� -- ------��eg�strar. . . �" "'i ' --- - : �•:. r ._ ' � .� — . ' � � . . . . . . ��"� � 1j1 :�:_!. Evarisvi Indiana 12-29-�� • sEAL - �., :: : .. . . . I �. f ' � _ � � �, . . I •' . . - '. • ' 4z d�4 . .. . �. �'-� i:� .' : i . „ ._ .. . " I . I NOTE:. Recorded lotally in Book No. ______________ Page No. _ _ �_____ � � ' � ' ' �' � � � ----• " F'EE $2 00� - �S : , • �g�. . 9 .. nnnnnnnnnnnnnnnsns ' ' .�� �' ..� P ;' . - . . . � Q0B0060II�O�OD�Q��A�tppQfi�p�gppppppp�BO�IA • : ' � . . . � . . - � - � . =t. / �