Death Certificate - Hubbard, Donald L_5/4/1978- �t' .
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RECORD OP DE.1TH
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. GIBSON COUNTY" DEPAATMENT OF HEALTH
-.. PRINCETON,INDIANA
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.+
TffiS IS TO CERTIFY, that our records show nntvar n r_ uttnRQg� died
10�21�1977 at 8��OAM RR �1 Francisco, Ind.
month day year hour of death street, hospital, rural
Age at Deatli 53 Se�t M' _Color �h' NIarital Status Married
years write whether married or single
Myocardial infarction
Primary cause of death given was-- —
Signed b}-
' James F. Peck, M.D. Princeton, Ind.
, phpsician or coroner - » address .
Place of burial or removal ° St. Joseph Prin�ton,, �nd.
name of cemetery address '
Date of burial 10/24�%7 Colvin & Son Princeton, Ind,
. F4meral Director address
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SEAI. Signed '/
Gibson Counry Health Commissioner
Gakland City, Ind. 5/�/78
address date
l.ecorded ]ocally in bool: No.—}[��_Page No.—�?�iled: 101��72