Death Certificate - Kelley, Edith Irene_12/11/1975I RECORD OP DEATH �. �'
C.IBSON COUNTY DEPARTT4isNT OP HGALTH
PRINCETON, I4DIANA
THIS IS TO CERTIFY, thnt our records show _ EDITH IR&�'E SKELTOPt Y.ELLEY a��
'il%3o/75 at 8�45Pr� Glb. Gen. Hosp. Princeton, Ind.
month ` day year hour of death strcet, hospital, rurnl �
, . . . .
Age at Death 6i Sex Female Color � t�hlte �Tarital Status hlarriec9
. yeara � . - . - -. � � write � ivh'ethet married or _single
Primary cause of death given waa Acute mvocard ial _Snfarction -' -
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Signed by Rrxt�.xink, n 11 P�'lx�ss�on-, �n�,
- . , phyeician or coroner . address •
Place of burial or removal Z• 0. 0. F. PrinaP .on • IntL.
. - nnme of cemetery .__ _. � � address �
Date of buriaL 12/'�/75 xan�all Funeral .&o�..=---?z-�nae�orr,�-nd-.
' Funeral Director addrcss .
G�G���� � �� < �.�
SEAL Signed__.
- Gibson County Aealth Commissioner
Oakland CitY. Ind. 12/li/_�
. . . sadress date
Recorded locally in book No. 9 Page No.—__l� Filed: 19�4g�/�
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