Death Certificate - Keller, Mary E_12/18/1985RECORD OF DEATFI
� •
� ,�
GIBSON COUNTY DEPARTMENT OF HEALTH
PRINCETON, IA�DIAIhA
'I'IiIS IS TO CERTIFY, that our records
�G : d71 �171:7
3 / 10 / 83 at 12:30 P.M. R.R.'�,1 Coalmine Rd. F`t. Branch, In.
month dey year hour of death street, hospital, runl
Age at Death 81 Sex Fe�n�le Color �'ml� Marital Status ��1�
years write whether married or eingle
Primary cause of death e cen was �dio pulm�nary failure, Acute myocardial infarction
Bruce C. Brink,D.O. Princeton, In.
Signed by
phpsician or coroner address
Place of burial or removal St. Thomas Knox Co. Indiana
name of cemetery address
Date of burial 3/14/83 Stod4hi11 Ft. Branch, In.
Fh�neral Director address
SEAL Signed�� �1G'• "�`ae��?�:'
Gibson Connty Health C 'oner
Oakland City, In. 12/18/85
addzess date
Recorded ]ocally in book No. 10 Page No. 87 F;1�; 3/16/83
