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Death Certificate - McGillem, Charles_3/19/1973'• �� .�. :,. �� . �. �.._. . :i.. i ' ' ! '{ - - ' ��• � ;i' : � � - � , - RECORD -0N:'DE4TH .�J '• .� '` = �.. •' ' ,' .i' , r +� - ; ` . • iGIBSO\T COti\'TY DEPART\IEATT;OF,HEr1LTH ' � �� :._ _ � .-^{ , _ - ��`' .'+�. .� ; ':PRINCET01 I\DIa1A � . . . - -. .''.. �!�' _ " : .- � �. �' � .. �.' �. ;. -��', . �. _: ' ' i;' �':_ THIS IS TO CERTIFY, �that our iecoids slio« �- ��' - CAAFiLES MCGILLEM ,_!' •. �died'. .. , _ _ ,, . _ . -- ; � ; • � .,, ,�, }-„ � . . - `'_ i ; , ' . �_�T,;,_ �. ' .»._.��._:.�q�� _.,. ._�,.,+F;.1:APM r,ih...GPrr.�Ansn..'.Princeton._.Ind. �. ._ . _ month� . � da}-: �. ' . 1,. :" 1� . �.' ::_e� . "? Age at Death� � 66 -° Sex! L� ` - :.{; ;,-t� �_' �years�!_ .: _ :tr..l. . �� •Primai y, �cause' of � death �given w; i �.: .il. ' . ' �. ' '_year _ � � hour of;deatht :'street,'hosp3fal, ruial :_ •'�' ' . . . :.` + .I�.:'� . - i'..'�•'.':'.. � '..' 1e •� �Color -whl•_te =. married:_:::':: '' _ . �. _ _ - - " � �crite- ichether'mairied ,or'single..:, � ' . � ` � ' ' . '.. � 'i`. � . �'M1. - � �... � .., � �.,.�. `� Metasta'sis csncea:of lung_ ,- ' 1S '' ,r: .i:- -� .i,, ��.,. - . �� ;.�". 1"' . �_ ..�.: . _.!' .�rf�'li' ' � 1 "i� s` . .. �4: ;- E. �. '.-..�� l-- ,� '-. , �1',� � s - llm. E. D e I�ID OaklandCit - S�gned b3 - Y r- _ 9�Zn�. _ ' , . ' �' - �' - � :physician or coroner �� : i � . �__ 7 address . � _ � � i y .� : � � � � Place of bm�al or iemo�al � "Martin' � ' � �,�txl�s-_P_j�kE�o,. ,�pd:. � � ; � � i' . 1 ; (i— � name'ofrcemeter} ji �� . _�� 1 ' ' , '�_ addressti:� I ° I � . � � -' '. �. . . ' . . S-: ' Date[of buria�,�IZ_2 ='" � ��b-S;Chmutzl2T - AAkl� ' - � � '3;,' . ` ' -' �' `- � :t�neral Director- .:` .��• �� :. �_ aar _ s .,_ _ :_ . _ ,. � , - , -:� ; =,. . ' -: ; :: -� , �$EAL � ' � . �' � : t � _ S�gne�l � ,L�,� .�t : �i1�!" �-- .:;' _ ��,, „ _. � �+" � Gibsoii'Counry•._ ealth;Commissione; .� � ��. +. �� " _ 1 s t: - t + � , ' + . ' Princeton.�Txi=d � z5��'-� . N„ � „' . i � . i .t' �address:%. _.i_ .�. �. r. . �._ :i .Date " . , i . . �� -' -� . '. � :' �,� �- . ..c -� �' � - Recorded locall�-:�n book No 8� 'Page r'o�-1�l4 � F�led:�L�2 - ..�. r— �� _ � i — � .�; �' _ .� ,�... - :l� ��_'..i �i �.�• i � . �' �'_ ' ;� ' �:_ i ,. '� �,. -,��.� � � �� "C� � J ,�. � ' t ;l+ ,� _ ' .__ ." ' ' . - .' :�_ ' - -. V � -' � � - - - - - �. - '� -r � :�'� -' ' � � �s ' i�'' .. . ' �i '. . . ' . � . . . . . '.. :� , . .. :.� , .. �.5 . ! . ..'� ..e ...,� . • . ... . .�... .. .. . . ` , .��:... . . . .'.