Death Certificate - Lafferty, Mabel Maxine_5/28/1964Locfu. C1�' DEPARTMENT OF HEAL�I
RECORD OF DEATH TEnnE Hnu�, INDIANA
THIS IS TO CERTIFY, that our records ahow:
Name m���. m� ���,�,
Died �r-�-i.Z 3� ��rJ7 3:�0� �l,�l., �.IYLi�OIl �iOhhd,.Z.G.i.
MONTH DAY YEAR HOUR OF DEATH STREET,HOSPITAL OR RURAL
1 �
Age at death ��3 Sea `�'G'£'Q Color ���'e m�'�"e'd' ��"
YEARS WRITE WHETHER MARf21EO OR SINGLE
Primary csase of death given was h�.C�i/��A'C G'(�,P'n'��G/l�1ylARl(t' O�' iJ"vP1l'.
LICI.PJ1.0—C.GILC.I.tWITIG,. CLE/yC.2t1.C�.i-1LCL CULOYL.
Signed by �U,�,CIYIl.�.PMUII.� Tl.�, �2/1/Lf. �GL1�2,� c9YU�.UtlL(L
PMYSICIAN OR CORONER AODREBS
Place of burial o�l ���0�.2i1Lwn, i1e�.on,i.c.�,f. 6�an}z, �Id..CyO �OU.►1.��„ ciYI.C�A..CiI'Ut
NAME OF CEMETERY ADORE65
6�un,ir.C-rt�b�57 �.Cfc�h.cu1. �ur�,�. ��ome �e�vin J1c�.�t.e, �nd.i'an.c�
FUNERAL DIRECTOR
SEAI. ' Signed v Vlll.LU-�.L 7fl.�r1. g�y,
- - TERRE flAI9TE� INDIANA mrna �7� 1�j�n�i
ADORE5,5,,"' y DATE
Recorded locally in book No.�age No. ���iled �lrY�- �� ���%
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