Death Certificate - Koerner, Pansy Lorain_4/13/1978'. � .:L�" � ' ..-ae,
RECORD OF DE �TH
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GIBSON COliNTY" DEPAF.T\IENT OF HEALTH
PRINCETON, INDI_4NA
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THIS IS TO C�PTIFY, that oui• records slio�c PANSY LORAL•fl KOERNER died "`
' . 2/13/1971 at 1: lOPD? DOA �nlirth Memorial Hos�. 0�'�and C; ty, Tn�t _
`� month day yeaz hour of death street, hospital, rural -
Age at Death 55 Se� Fe' ' Color �'�h• :lIarital Status !�Iidowed �
pcars nTite ���hether married or single
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Primaiy c:mse of deatli gi��en w1s CardiaC arT�est
Signed Uy H. A. Peters. DO oakland_C�ty, Inci
'" ph}'sician or coroner address
Place of 1?urial oz• remo��al _ Montgomer�____ Oaklancj�i�Y. Ind.
name ot cemetcry address
Date of bui•ial 2�16��! Corn Mortuary Oak7.�lld_�'1_ty, Ind .
- FLneral Direcior address
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Gibson County Health Commissioner �� �
Oakland City, Ind. � 2�17���
address date
Recorded locall�� in book No. H-�2 Page No._�_Filed:-21s7_�?%
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