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Death Certificate - Myers, Maude F_6/29/1972, . . . . . .. ;� RECORD OF_DE�1TH.''� .'._:� .. , �'- �� 1 _ -- " GIBSO\T'COliNTY �DEPARTIIE\TT�OF �HE9liTH'' ' � _ - , -�� . �� . . �'PRINCETO\ IA'DI:4Na-. � . .• � . ._ , � , - ' ,... _ ,- '. i�fAUD'� F �i�iYERS � - � � . , �. ' THIS IS TO_CERTIFY, that our recmds sho« d�ed �' � - , _ .. , �. _ _ - .,. , Mav �4,. 1972 �at•2ejM�/Gib'•.G'en.�'Hosp: Pri'ricetom,�`Ind:� _" � � ".morith �dav , �.pe�r =• : �'fiour"of 8eatfi'.� � . : �street,-hospltal,-ru'rel � .,. ... .. �.� . ' . � .: � ' ' ' 76 • F.emale :'' ilriite '-� t�iarr-ied �< < ''' APe,at Deatli Sex ' Coloi — - - - .. ,. y + .. . . . ° � . � . . �ears : .. . �.' .. ; � .. : . . . - � . -: � w'rite �wfiether. married� or. �single. . , ' . . , ,. . . . _.. . . .. . _ . Primary cause.of death given wa� �PulmonaTy.Embolus., ,T.ight. - _ � � ' .. . . . . .�. -- '.y --,i: - .i -. -t�- S�gned bv - "R. °_. Weitzel --hID �- PrincetoZi -tnd : � - - _ � �� . � � � , �. � � � .+: phSsician or coroner ' � •. ? � . � � � . addres� ; : . � ' E � Place of bui�al oi removal • -;idhite Church � Princeton, Indt..- �� _ � . , - � � ' ' . . _ ' .nartie.of 'cemeten." " ' � • . -..'address� , ; � � ,:.^ „ - - :Dateof.bui•ia �'S�'6��7z. Colvin'?c.Son `'Pri�nceto Znd:• ''" ' . . .. - ' _ . . � . Funeral'Directoz �... . ..� � �.� �.j. n � . . _ _ . . . . _ � . i � : � �;� �. _ -, q7'✓ ,SEAL ' S��e• � ' _ _ ' ; �� t �• �-= f- �' �.--�'- . "- "- -�� :- Gibaon Countv Health Comm�ss�oner. ; . F. .. 1 � �� . _ . .. . %'�9/7 • - �Frfnceton,; Irid . 6 L 2'= ' � . - � - � � . '� . address . ,�t Date� •��' - �. -'�: . - � ..- . � . � ' ,� . Recorded.7ocally,in Gook No. _ 8,' 'paae I�To.-, 50.- Filed: 5%8/92 �,.. , � M ; � . . , . . � . . ._. ..p,��.. ' j' . .. � . • . . . . . . ^ i . r .I�,� �� . -� , ' .. •r . �� ' � .. . � . . . � 1 . . . . . . ' _ " ' ( . . . `.' � . - . . . . . . . . .. . . . .. . � . . . . . . . ... .. . ... .. ..... .. ...'. _ .. . . � . . . . . . _ _... •