Death Certificate - Kirk, Essie A_12/4/1975U�.-,-w-��
RECORD OF DEATH
� •
GIBSON COUNTY DEPARTIiENT OF HEALTH
PRINCETO�', INDIaN.�
THIS IS TO CERTIFY, that our records sho�v GSSIE A. KIRK died
month day year hour of death
02 S. Seminary Princeton, Ind.
street, ]�ospital, mral
Age at Death 82 Sex Female Color «hite �jqarital Status Married
years write �rhether married or single
Primai•}- cause of death given was Acute cona. heart fallure
Signed by R. S. McElEDg�. , N.D. Princeton. Ind.
ph}�sician or coroner address
Place of Uurial or removai t4t . Ol 1 ve 1�t . �lvmnus , In�7
name of cemetery address
Dateofburial 5�26/�3 Colvin & Son PrinnPtn,,, jna
Funeral Director address
SEAL
���e/J�// /y l C ~�.0
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1
S'1v11C�
Gibson County Health Commissioner
Oakland City, Ind. 12/5/75
address date
Recorded locally in book No. � Page \To. �Q Filed:—h/2�/']�