Death Certificate - Martin, Verna Katherine_3/15/1982_ � � _
f:'
RECORD OF DEATH � �
GIBSON COUNTY DEPARTT4ENT OF HEALTH
PRINCETOA', INDIA?�'A
TfiIS IS TO CEATIFY, that our records show VERiVA KATHiiRIPIE MARTIPI �ed
7/1�76 at 5�5�PN1 Gib. Gen �{osp. Princeton, rnd.
moath day year hour of death stree!, hospital, rural
Age at Death 47 Sex �e � Color �'1h � n4arital Status m�
years write whether married or =ingle
Primary cause of death given was Pneumonia, leit lung
Signed by
Place of burial or
Date of burial_
SEAL
James r. Peck, N.D.
physician or coroner �
removal Shiloh
name of cemetery
7/3/ 76 �io 1 de r
Fiineral Director
Princeton, Snd.
address
Hazleton, Ind.
address
Owensville, Ind.
address
f.t) G�1 �rlc � � � ' = �
Signed
Gihson County Health Commissioner �
Oakland City, Ind. 3/15/$2
address - dau
Recordecl locally in book No. 9 Page No. 28 Filed: 7�9 7
6