Death Certificate - Haley, George C_10/28/1975RECORD OF DEATH �
GIBSON
�
COUA'TY DEPARTTZENT OF HEALTH
PRINCETON, NDIANa
THIS IS TO CERTIFY, that om• records sho«� GEOHGE C. HALEY died
Dec. 24, 1959 at ii30AM
month day yeaz hour of death . street, hospital, rura
Age at Deatli 27 Sex p��e Color Whlte _Tqarital Status Marrled
pears write a�hether married or single
Primaiy cause of death gi��en wa� MyocarditiR
Signed Up •TOhn R Fo�cic L+IB Princeton, Ind.
phy;ician or coroner address
Place of Uurial or removal I. O. 0. F. Pbinceton _ Ind .
name of cemeterv address
Date of burial 12�2'��59 Colvin & 3qn Pr� ncpton, Inr�
Funeral Director address
SEAL
(j(/ •� l.�%i%t � u'�"IGI ( �.0
Signed
Gibson County Health C missioner
Oakland City, Ind. 10/ �/�t
address date
Recorded locally in book No. 6 Page \TO. 2�A Filed: 1�/��,/�j1,1
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