Death Certificate - Lawrence, Clyde Basil_7/11/1973DUBOI�OUNTY HEALTH DEPART '�NT
COURT HOUSE, JASPER, INDIANA 41546
CERTIFICATE OF DEATH
THIS CERTIFII�S THE OFFICIAI. RECORDS OF 'PHIS DEPARTMENT gHpW Z'HE FOLI.OWIN6
HARRIED �] SINGLE ❑
xn� ._CiYDE.. BASIL _LAWRENCE .................. ... ---... ncE .._6�...... sss ._�e. wmowm ❑ Drvoxcm ❑
PLACE os DEATiiStOZ'IC.,MB,IIlO�'1LI,,,�OSD1t8];_„_,,,DATE OF DEATH ..._JUIIO,ZO 1957
- .t .................._............_................
8.TC1�8�. TIlfBI'Ct.
CAIISEOF DEATH .._�........_ .......................................................................................
Coronary Thrombosis Arterioaclsrotic
SIGNID sY _Frederick.._Lt.._Kiechle.t.._M.D•...._...DATE OF BIIRIAL ...._JUIIO.._�.T.. ZSS% ................................
(Physicisa, Coroner, Health Officer)
T,amb & Son ...................................................nnnxFSS .Oakland._ City, IN............................................
r�n�xnt. $on� ........................ ...............
xnn� oF CF.MEPERY ._OBIC .Hlu C81�i.8I',Y........... ADDRE59 j�inalow, IN
......................... . ................................................................................_
DATE ISSIIID ..........._M3p�._�?�.._ZgIO ......................................RECORDID BOOg/, NO. .......i4..H....... PAGE ..........�!:!.:�..I.. n 1'" `
SIGNIDG����!...Cf��! ._� ...�i��r ��Cl V N"' "/
(Health Ofticer)
6 E A L