Death Certificate - Hayes, Claude J_1/21/1992� �
�GflRD OF DE.�TH
GIBSON COUNT'Y DEPART1fEVT OF HEALTH
. PRItiCETON, INDIAN:1
'i'fiIS IS TO CERTIFY, that our records show
mon[h daY
Age at Death �+ �_Sex
yeare
Primary cause of death given
Signed
Place of burial or
year
—�`"`�
was <Ld.
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or coroner
a e of ce te�
hour of deafl
write
� G�'�-
merried or aingle - _.
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addresa
addrese
Nral
Date of burial /�' �S - /� -� ��o�� - X l ° � �%�°--�% � �x-�-•----�
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_ . • . - addzese - � date
Recorded locall� iu book No. H--�l) Page No. xT --, �
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