Death Certificate - Kiesel, Mary E_8/7/1986RECORD OF.DEATH • �
GIBSOV COU�ITY DEP.9R'1'3'IENT OF HEALTH
PRINCETON, INDI.INA
'I`HIS IS TO CERTIFY", tliat our records show MARY E. KIESEL died
Dec. 20, 1985at 12:14 A.M. Gibson General Hospital Princeton, In.
mant6 day pear houz of death street, hospital, ruial
Age at Deatl� 67 Ser Female �]or White aqarital Statu� Married •
years write whether married ar sng!e
Prunaiy cause of death given was ResDiratory Failure, Pulmonary .E�bolus
L�. l.�ivuy��.5 C. C�f_`���c, N_P. Evansville, �In.
Signed bc _
� phpsician or coroner address
Place of burial or removal Ho1v Cross Ft. Branch, In.
aame of cemetery address
Dateofburiai December 23, 1985 Stodahill Ft. Eranch, In.
Funeral Director address
0
SE:1L
Signed_____d!'Z'�< �����'�� —
Gibson co�nn� xzat_n C mis=_ioner -
Oa�:lanc Ci
add.^ess
In. �eC. 21, 19S7
Recorded locallc in bool; \o. 10 page \o. 1f'� Filed: December 27, 1955
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