Death Certificate - Hickrod, Max T_4/5/1994. � `
G=BSON COUNTY DEPARTMENT OF HEALTH
800 S. Prince St.
• Princeton, Indiana 47670
8,12-385-3831
R E C O R D O F D E A T H
THIS IS 1'0 CERTIFY
that according to the records of the Gibson County Department of Health,
MAX T. HICKR011
Died on 08/31/1993 at 7:30pm
Residence
303 N. Church
Ft. Branch ZN 47648
Age at death . 66 Years Sex: M
Marital Status: Divorced Color: White
Cause of death: Myocardial Infarction,
Generalized Arteriosclerotic Cardiovascular Disease,
Congestive Heart Failure
Signed by: Quentin B. Emerson, MD
109 N. McCreary
Ft. Branch IN 47648
Place of burial Walnut Hill Cemetery
or removal:
Ft. Branch IN 47648
Date of burial: 09/03/1993
Funeral home: Stodghill Funeral Home
304 W. Locust Street
Ft. Branch IN 47648
����.°�.��' -
Signed by
Gibson County Health Commissioner
S E A L
Oakland City, Indiana 04/04/94
Address Date
Recorded locaily in Book No. 12 Page Yo. 73 Filed: 09/08/1993