Death Certificate - Gwaltney, Luster N_10/10/1986RECORD OF DEATH �
1�
GIBSON COUN'I`I' DEPARTMENT OF HEALTH
PRINCETON,INDIANA
LUSTER N. GL9ALTNEY
THIS IS TO CERTIFl, that our records show died
Auqust 20,1984 at 8:20 P.M. Forest Del Nursing Home Princeton In.
month day year hour of death street, hospital, rural
Age at Death �6 $eX Male �lor WhiteM�t� g{��s Married
years write whether married or �ngle
Primary cause of death given was_ Medullary Failure ( few Hrs. ),Metastatic
-Carcinoma of Brain ( 3mos.), Carcinoma of Lunq.
Signed by G. O. Dickenson, D.O.
phpaician or coroner
Owensville, In.
address
Place of burial or removal wa 1 n„t H; >> Ft RRanrh, In
name of cemetery " address
Dateofburial August 23, 1984 Stodghill Ft. Branch, In.
Flineral Dirnctor , address �
SEAL
Sign ��'�'%/G�. �6.iv.�J
Gibson County Health 'oner
_- Oakland City, In. October 2, 1986
. addmss datc
Recorded locally in book No. 1� page No.127 ���: August 23, 1989
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