Death Certificate - Hisker, Ada Viola_12/9/1980e-
RECORD OF DEaTH .
•
GIBSOI�T COUNTY DEPARTD'fEI�TT OF HEALTH
� YRINCETON, IA'DIA\*A
THIS IS TO CERTIFY, that our records sho�v ADA VIOLA HISKER died
6/21/72 �" at 11PN, 210 S. Race Haubstadt, Ind.
month day year hour of death street, hospital, rural
Ade at Death l+ 81 Se� =-Fe' Color �• Marital Status Married
� years� �� write n-hether married or single
Primai•c cause of death given �vas Cardiac com�ei�sa.tion
Signedby 1-Tarnl�7 PPtiPaaan,, MT) H3lllLtar7±�_ �i
physician or coroner address
Place of Uurial or remova] Sts. Pe�r & Paui �„h�+�_YK�+,���,_
name of cemeterv address
Date of burial 6�24'�72 Wade Hai�h�tar�t,_�
Funeral Director address
SEAL
Signed w `��4/j'�2 �,e�%y,�r %'��
Gibson Cou ty Health Commis;i4lier
��
Oakland City, Ind. 10/2/80
address date
Recorded locall}- in book \TO. h-51 Page No. 28FSied: 6/26/72
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