Death Certificate - Kirk, Perry D_3/21/1986IZ�CORD OF DEt1Tfi
GIBSON C•NTY DEPARTlIENT OF HEALTH �
PRINCETON,INDIANA
PHIS ]S TO CERTIPl, that our records show PERRY D. KIRK died
,
Jan. 25, 1986at 2:50 A.M. Gibson General Hospital Princeton, In.
month day yeaz hour of death street, hospital, rural
rlge at Death 80 geX �1a1e Color j�hite n.Iarital Status r�arried
pears write whether married or eingle
Primary cause of death given �vas_ Respiratorv Arrest Acute Pulmonarv Edema
Pneumonia Carcinoma fo Lunq(riaht) Emplysema
5igned b3' K. Murthy, i�l. D. Princeton, In.
physician or coroner address
PI1ce of biu•ial or removal Shiloh Hazleton, In.
- r.ame o: cemztery addre�s
Date of burial January 27 1986 Colvin Princeton, In.
Ftiuierrl Director address
SGAL
.SlgClari - ° ���"" I �`�`�4e�6fi�
if4�
Gibson County Health missioner
Oakland City, In. Feb. 3, 1986
address date
Recorded locally in book No. 11 Vage No. 2 Filed: Feb. 3, 1986