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Death Certificate - McDowell, Arvis Lloyd_6/13/1972•� 1�. �.. .. . . . , . . , • . . . — s — .—.. � '� � ... . � . ,�' _ � .� /1 RECORD.OF DE�aTH'.'� c.s� �.'' - � J� � � + , ., . ' ,: . _ . ' �= ' � ' '- , GIBSO\T'COUA'Tl •DEP'ART\IEATT OF HEALTHL� � �.-:'.�:�� . t . �c .- . . ' ` '.; PRI\CETO� INDI:INA. . � _...• . .. . , � . - . "� - . • .� _ . � . . . .. . �. :�� - . !�� ' . -�',TFIIS_IS�TO CERTIFY,�that,oui•�records slioi� - • ARVSS�I,I;OYD'TdCDO'dELI,^ .=�died� • _ ". . �. �. -_ _ ' - � . . _ _ � t4ay 22 - . � 1q72 � at.12_•�P.�? =QLt�_ �n.�insp = Pr'inceton ��Ind month ' � � � dav ' � '� year •' � � hour �bf death �� - • � �� streef; �hosp�tal,� �iural � Ave�at Death� 68•' SeY -I�iale ' . Color-� : ` .�ivhite : -.I•iarried ��•� � � �' • . years � - � � � � • - � i � �crite a�kethe� married oc.� single � � _ _ -Priinary�causetof .deatli �,nven-wae Y'PuluionaTV �Emliolism � • :� - . _ � - . _. . . � . . _.y . _._ . _ - - . . �, _ . . � . S��ned by ' �idm. R �3deIls;_ 1+� ' Pr.inceton,�, � ,' - . - . ? ph} =uian or coTOner : . ' ""' � � -� � � � � � � � eddrnss - -- : � -Place:of bunaL•or removal ' roTS.ythe Oakland 'Cit�; Tnd`� � ' - _ - �, '' � -tname.of;cemeteri•. _. _ �address:'._ � '- �'' _ � ' .' . � , ' . - � ' . � ± .� �. .:'. ` '. ' ' - , . . . Date;of buria �.' •�24'� %2 �-•` � � ,�� Corn Mortuar� - klan'Cit--� Ind.' ` '-f;= .. - �-- � . �F'uneial'�DiiecWr:. - '- - ' - ' �.add�- . - '�,:.':{;' - , ':.I . ,: ' ,' i : - ' . '. ' ^ ' SEAL" ,�i � : Signed - , , +Q � , � � � � � �- � , : . Gibson Count}?�Health Comm�ss�oner � . • t�:' � _ .. _ .. , . , . . } �4 ?-" - . -. : �� 1� . ; - , _. -=~ �.=. =' �.�. ' n•; ,: • ' 6/.13/72 _ �•princeto INd _ + � . ' � _ � '.address � S ' . ' Date. �; ' � " . . . . " - . . ' p:..' � .' _ - � 'Recorded localh• �n,book \To '• . � •_ page No_ � - �i', F�led; �[t5/�9 _ � =(_ �. � ;� . _.< _�� ,: - -- - • - • : . - . - _. . � • . . - , - - . � . •, . - - - - . . �,. _ . . _ , _ . - . .. _. , ._ . _ . _ - : • _ - - - _ ,� , _ . .. � - .. _ . ;' ., . . . ... . .. .. _ . . .. ._. : . ?