Death Certificate - Ivey, Alonzo T_7/28/1973,� 1
RECORD OF DEATH • * ' - �
` • • • ,
.. �` GIBSON COUI�TTY DEPART\iENT OF HEALTH
" , PRINCETON, INDIAA*A • - ' .
THIS IS TO CERTIFY, that our records show �1LON70. T. IVEY - �died
12/10/72 .,+i�.�c�u ^--- _ _ . .. .
month da ear . hour of death �e - • 1 i�—���---
P. Y street, hospital, rural . - �.i'-,
"' • '' "' '��,1i ' ':9}:l
- Age at Death 8% Sex Male Color White t�r ;. '"' ����. "' •.
. arital Status lidowed =
' ,� � years , . .. �arite whether�mairied or single .
Primary. cause of death given was TtremS a • � '
._ . =., _
, .-. .::
Signed liy �3Z�1izE_� 8 P tin Pton, Tnd -. : ..'
. _ � �. phys�c�an oi coroner . address � � �'-a .
Place of burial or remocal Fatoka Patoka, Ind. �� '°'ti•''
- name of cemetery � address /' � ,
Date of burial � 2�13�?Z
SEAL "
Funeral Director
_ . , : . '
Signed
`��r�E��c���' . '. .
Gibson County Health Commissioner � - �
Princeton, Tnd ��2�7� �� -
addresa .
e .
Recorded locally in� book No. � �Page No. h3 Filed: 12�19/72