Death Certificate - King, Grace G_4/8/1986RECORD OF DEATH � • ' '
. 4„ ,� ;� GIBSON COUN'PY DEPARTMENT OF HEALTH
• PRINCETON, INDI.IIQA
THIS IS TO CERTIFY, that our records show GRACE G. KI1dG died
March 21, 1986zt 11:90P.M. Forest Del Convalescent Home Princeton, In.
month day year� ha� ot deuth � street, hospitsl, rural
Age.at Death �� cerFemale ��or Whiterfarital Status Married
years � � write whether married: or eingle"'
Primary cause of death e ven wa� Renal Failure, Hypertension Cardiovascular Renal
Disease
Signed by Jerry Becker, M.D.
physiciaa ox coroner
Plnce of burial or removai Walnut Hi11
515 Read
name of cemetery
Date of buriat �arch 24, 1986 Colvin
Fhne.�l Director
SE�L
Evansville,
address
Ft. Branch,
address
Princeton,
address
In.
In.
In.
Signali ��i�� ��+Z�i7
Gibson ounty Health Co 'ssioner
�
Oa:;land City, Zn. 3/26/ 86
address
Hecorded locally in Uook No. 11 page I�'o. � FIled
0
.. ,
. . �.
March 26, 1986
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