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Death Certificate - Haggard, Laverne_4/25/1967f. . _ _ . . . . . . . RECORD OF DE11TH ' • . � , � -� , . _ • . ' - - , . � _ � - ' � � , , GIBSO?�? COUNTY DEPARTI�IEATT OF H�ALTH • , , . - . : rRrxcETOrr, ��nia�:� " , .. - . . . , ,. , , . - � : : • � _ • . _. _ _ _. .. _THIS IS TO C�RTIFY; that our. recor�l.s �sho�v: , La s�F-FVE L•. °A�GARD d�� : . - . -• . J„Iy � ' �19 . �1966- .' . �at9 9Fi=Ii:R.- 'Princeton, Indiana : - � �month � � � ' � da}•� • � year � � � � � � - hour �of death �. - � - � stmet, hospital,.runl � 4 - Female �.White • ' Ma'r.ried. ' - • , Age at Death 7 Sex Coloi- �� - ' .' ' _ }�ears � � , ' � ' � . _ write �whether married or smgle.;, ,; •. Primary cause�of death given �va�' ' Self' Inflicted Gtmshot''tJOUncl '= ''' ' _ . . . . . . - Signed.:by �obert J . !:lade � Coroner . • � Haubstadt ;� Indiana : � . _ ' ' . . ' � . physician or coronei•. . . ' • � . " � "' _ . : address ' : . . � - Place of Uu�•ial oi• reinoval.'I•0 O.E. Cemet=rY �?'rinceton, Irdiar_a � �- . � . . ' . � . . name of ceinetery•, .. . �- , : . . . : . . . . address � --� � � � � - , - Date of bu'rial -7=22-66 Colv.in, R• Son - Er.incetcn, Ind'zana � . .. .' � ' � F�neral 'D�reclor . . .. : �� . . � addrns � '. � . , " . . . . ".�SEAL - 4 Signe�l �/f.iH� �1/ .�2./�Lcz�i.cPil/ �/ •X/ . . . . ?.` . �'"�+ � ' � � 'r. .. �Gibson'County _Health Commissioner ' � "- - � __ �. - _ _. . .. - . Priric,etom, ;ndiana� 4-25`�67 .� )_ -.� , .. _ - . . . . .- _ address . .. , � . � . .. . Date � . . i;-. ,_. '� '' . - .. , . _ . � . . . .. . . i.. . . . . , . . Recorded locally in book No '`�'S� page No. -87 � -. _ ,. . _ _ .. . . '�'^i } Fi1ed 7-23=66 ; _ . . . �._'