Death Certificate - Gray, Charles Harold_3/8/1977RECORD OF DEATH .
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GIBSON COUNTY DEPART\IENT OF HEALTH
PRINCETON,INDIANA
THIS IS TO C�RTIFY, tliat our records show CHARLES HAROLD GRAY died
1
2/21/77 at 12:15PM 302 E. Vine FT. Branch, Ind.
month dap year hour of death street, hospiial, rural
Age at Death 69 Sek Male Color 1dliite�farital Status Married
cears write a•hether mamed or single
Primary cause of death given «•as Cerebral hemorrhage
Signed by R. G. Geick, M.D. Ft• Branch. Ind.
phpsician or coroner address
Place of burial or removal Walnut Hill Ft. BranCh. Ind.
name of cemeteiy address
Date of buriat 2�23�77 Stodghill Funeral Home Ft. Branch, Ind.
F�neral Director address
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s�gnea
Gibson County Health Com sioner
Oakland City, Ind. 2/24/��
address date
Reeorded locally- in book No. H-52 page No.—�Filed: 2�'z�%�77