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Death Certificate - Green, William Embree_6/1/1979�) . t .. . . . � � RECORD.OF,DEATH�` ,a'i'��. , _ � _ ' r ':,?� : � '_ �.'yGIBSON COUNTY DEPARTIISENT OF HE9LTH � �- � ' -� � � PRIr'CETO\, INDI:4NA � � �, '�� �, `.�� f � . .� . . _ - � - � . THIS IS•TO CERTIF'1', that our records show_____—'�dII.i TP �•7 F.NRRR� i_�January 23 195p 2•4.5 Ap1 Oaklar.d . __at_ ' _ month - - � � � day; " year � , . � hour of death. . �.;� . . ..f `. . . . _ .. ' � ._ r1' � t�D th 6� �x i�?23e Color _W$i:t�— � idar 5 ' •1 yc2B ':Y. � ��� '' p ': } -�:� . . �- �;y �t`. � '� : � Ra'r . .. , ".,..`�i �s,;; Cit;�; Ir.d.::i:osp - street, hospital; . - tx 1 i-.r. i e.� : �= , �. ge .a �' Qa _ - � years � u'rite �ahether married or. single; i . -- �_ ^` i'.; ` . . �'� -' Hyp�static preumonia � , r:.}. •Primary cause of,death given was -- — r ... . . ._...'. . . . . . . , . . .FS.b.s�LR� i." ��9,.5.1 ii�ev� rf.A�_i'Po}'c�+c� ll../l_.�•17n�_j :(�A�l��AYI� i�5tgnea AY - _ � ------.•-_- -- ...— - � . ._-y�•:�� .. " physician �or' coroner - .r� - �jPlace of bunal or,remo�at Montgomery Cemetery, Oakl< �� �j �-1. : a � t � name..of cemetery• � � . �� � x " �� ' 1-2 68 " -Lamb,Funeral Home� Ot • :`Date of,bur�a� � � � -' Ytineral Director - � � .. . _ SPAli � ;'`, Fi�led: i1-25-68 : Sign �rli'onfl�� f�'�• addre=s � r.d';�'S.ty_, _Indiana � ���? address - . � t .,,,.,, r� �+-' :' . .. . t t iS`h%�.ti�Y ,n,,..a 'vi+... .r::.a:�o.,o'• 1*...:�:I �".. ,_,"? _ . " Princeton, � ) -. . . ._. � . � � . . . + . � � � ' i • � , address � t.. . . � -. � . � � . . .' - . . �. F 1 . � ' . . . I ,--Recorded locally m book No {A 5�� }' page No. 101, `�' _ , �, ` '^t, ~ k :( , .'t� � t'- � 2 4;y �t .y.' i ..i. a lf jE•f ' � ' -� a # °� ;i � ,�� {�fi �N; .i . - . � - - .3. . :s �„r ._ , - • , _ . � � I '__.��_'��__"__��__�._`_'_.�_'"_—_'_ __' '_"" _' _ .. . "__ . . na Fess � �. � _ . � ; `/ / L' .. � �%o _. _ - County Health'Commissioner �'S t.c<.: Indiana " �'.: `;.1-=?�5=t ..._t�- .3..�..... ' '- !? ._ <� • + ` i �r�.,} - �, . �'+ _ e E 3 - ' + i .