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Death Certificate - Kruse, Paul Martin_7/29/1975�1�x . -�'-_-- . RF.CORD Ol' DEATH - �GIli'SO\T COUNTY DEPART\IF,NT OF III?ALTH ; � PP.ItiCETO\', I\DI:1VA ,i �, b w i i_ TAIS IS TO CERTIFY, that our records s�ioti�—_ P'1l?L. "'1? �'It,; tinU ;E _� ,. _`�y 19� 1°52 at ].1:7.7�9r; :�1�. G�r..Hosn. r'rir.c=.ton:`ind�. - � month dap peaz hour of death - s[rce:, hospit8l, rural �• �, Age at Death �2 Sex �''�� ° Coloi• �'hi t° _ llai•ital Status ,1�?ar'rt �� •ears � write 1rHether niarried oi• ;in� �, Primary cau.;e of death given was ;�1�_uil fr�ctur� : Shock ; ' � , , ,:� . Signedb}-_ ��i,art r:" .�or,;�11-r=-"rar�'=" � :�ee�3rr ? r�.. �,.ti - physician or cm•oner address ' t " Placc c.' Uu:•ia! oa� :•en:o�°.! ' :'t. =a.i�1 :van�-e1ric?il �emeter!T r^t. Brsneh,=Cnc � ' � name of cemetery � address . .`� DateofUm•iaL. 5/?2/K2 i.�ih -nn�ral �:nr,o _ ��+; n,.��,r��-_IY,�_� — Funer:il Director nddress SEAL S�ane�. � �� . Gibson Countp Health Conimissioi;e—�— F*11nc�to?;� Iri[i. 7/2��7�_ addirss � -� d:�te , Recorded lorallp in book \o. ? Page \To._— �_�I'iled:_ i . . .. _ . ' . ' . _ . _.. . - .. - .. �� {,., . . . -_.. . .._.t .... A �.. , i:.. i�