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Death Certificate - Hayden, Robert_2/20/1961� ';� .1 a — - , P} , , , _ '; , , . � ,--� t � ti Q p a. ` .. _ e 1 `� �i ��;.i { � 1F '• �� 'Y _ CI ��-�. ji �� i � � (i,ii�l. .v ! r� � e1 � � � �e� � j p {j � i .�: � Vn �P�v ��.:� � "� � �� i � 1) C � i if i� �� 1� �9t S � j i �.i �i� . I� LOCAL �_ 'tj _..w �x f� i._ 1� .j$ Si .t r � �' _ � i �r�_ � a � � RECORD OF DEATH ��. � _•t` , �' ir y � � T: ` '� � 1 ! . _ s � i! l! � '.• �.-IS' � ! 3 �� t i � � . -� . . . . .fi . . , ��• .i l�` � � 1� '�. �s , �t ;" d � ,fi�:` �� , .`, CITY DEPARTMENT OF HFALTH+ �� 'f� `�., v - �' }� M � i7� ` � �PRI\CETON� I\DI.�14f - �- � . 7t � ,� 4 �t ' '- � ` � �ie� t. .___ i -. �t � i .� y�:. � � .'• � � 9 k � � tC . � 4�_.= �S .� ' f .f.��. �` t �•-. �. i . � �� . ! �� . � � dc . r . � �' � y� r +� - . THIS.IS TO�CERTIF.Y .that oui�iecoids show� ' : �bert'H�pdea":, j „!: i ,.• � `4 , ; ' i t i., �� C . , ..r ��" �_ -:_ �� .. i. � N: d12(j '�.. �� e:Se�, em8er; �. ��30)� - �' ,.e4•1958 # �"� i� ,cl;� i� ,l�ibson�General'Hospital� � : ; } � � - at OP.m. Ps'lnceton.�Indiana , .� ,,. montfi r- y� day+� : i��year� �!� - i9 hou�of;death:_ Fj `� street'hosp�tal'rural i".t� " �.�r � kr:�' *" . :. �{ . � L ,_ �, t �. .i�� j, 'i ��- �� -'� � � .1<. x ;r • .r Age�atDeath��, 51> t�•,�Se,�—Male i.`-��Coloi • �R�hite: '{ , _ _Marri'ed•.� � � _ �_'-'S °' ; ri' ae �` . yeacs � b� , � i ..t.^� . .5..�rL y � �. . I ! . � ��. ` � � ycnte. nhetheP mamed or smgle_ j; � . � '.'�� . t�. .0 9 .• .��:� td . tC . :>t � .5 �.1 .� � 'Y -j �r rl -L i' ,��. .� ' r,l't'%1 Y' ' 1 -�Cirrhosie',�of�Liver% t+ -t�� Y ') '-�� rr. sj'� Pnmary cause�of death'gi�en was t� e � t_ i� A 'G _ _ i -�� i._.. Y !( t i �" 't :1�� i � �� y, ti � - �� i �- .x, � :�.di.�_�.! li�- � ``_�..i! �'f(�`" ° .�t�f '` Y��^ ar,�. fe :i �i :� ^.iy: �. �-...�y - r '- 4 �.. C- i^; e 1.�y t *� .t� � � a�...'_' ... ' `..� . .-� .�=�.�_.. ' 6' .. 1_. i .� ki' � It (t � u' I . ' � � c ' i �t-� S�gnedby 'Jeaes F::PeckiM,D , •-�-�� Princetont`�Indiana• .� ; ': _! '_ -':Y � �l_' . �� ph�sic�nn�or�coroner[i�-...�F:'� iI ..�f � � �_;:�r �.��. . .��address_ ' � �t.. � _ • � <,' aY ( _'i� r .�.� ��'... A� 4• C '�.5.. �l4` — 'f tt .�`� . :-�" � ..;'� 3 Place�of burial�or�remo:aLM°�gomery Cemeteryj_" �y �' Oaklaad City.` In'diana , � r, �' ,; s�� ,;.r .,�'� : 'r . `]l:. f�,name�of cemetery` p.-��... ' • �.:� � �etaddre�si' . . � ' _.F�.: L . ' � �S� �'�p '��Js� T �'_ e ... /� -. �p. � � tt�'` 1a t �i' r�.- ..�! r _ � ,. . d�.'�1 7 !n: � `' �`��'- 10/3/58� {* Wr.ig�t & Bendall �i ,. Princeton,; 2ndiana - ,,,:, , .� = � Date ofiburiaL—�y — � 1� .�.�� `� � �,.b �J2.�`� ..< < �{�� D�tect}�" i � � �. 8. t�� Cb � Z � .l��.a � ad C �� r: i : � _ t �i:SEAL.:� .e�...�+ > ��° 1�...-.� Yt.S�gne " �' —_�K�!��-eO�Secy, = !x . i � f 4{ , '� �". , .i t _ 1� ' j {:. I..� f�i. �. � �� r. � i, �4 '1�. . .t - � . ., i .., s i.�� 1�, �� T��(C _� .,� .�� _` � � �.. �. .. PTSI1C6tOII'. TIId• c. i 10�%�.� .:_� _ ':, �aM 1 �_ r_ ,.r� ,k f� 7+ t !j-*1 . �i � ` r .i• s �i address ' i _ ' �� - _ .p -�� ,. :.t_�- - date ,� . . . . A'� _ � � � �' . i � r �.� t r �3 ��0 ��s� ��.r f� i ;. ) a r � �• �t� . (1 1 6 i� . •�� ( .�+L� i Recoided locally m%book _No " fi } Pa�e ATO'�' 2S0 ;. �� e? ,� 3� ,� � ' ',. � �� , ,v � E� � 9.. ,� � i=� e �� , ,� t ¢'�` .z- {y � �fn - fY . -� , � 1 t .�;i� � ��` i �4 �ti I �1. p '�1 ..�i � �� a .` �'' �t .'� j.., ��1 ��.. �• �� .* ax .�i �V -st ;�'i`� ' 1� ��- � � • 11 „ ,J i`� ' { ``{ ,' � �.'' � � _ ? � • � �� i J a � �~ � � .� � .,�.:d,1i i°-a r t r •e �° �. 't.i� f� r —T� � �' .� � �t. r t� s .I..-- . _ .. 9_. . _. .'!. _ �-.. . . .�,.. , !7. . :� - .. ..� .. �. . _. ..i � .. — .. . . _, . _ . .. . _ . '