Death Certificate - Maxwell, Anna F_5/15/1978RECORD OP DEr1TH
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GIBSO\r COUNTY DEPARTn'fENT OI' HEALTH
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THIS IS TO CERTIFY, that our records show - ANNA F. MAXWEI,L died___ ._L_�,i_
11 427 at 1:45 A.M�--�ihs9n�eneral Hn�=;ta1-,—PsinsPt�n- rn�_
month daq qcar honr of death street, hospital, n:ral
:1ge at Death�$ Ses�emale___Color?rLhite—�farit�nl Status Marri e�l_
years write K�hether married or single
Primar�• cause of deatli given
Signed b}• Wm. R. Well�,�.� Prin�e_tc,s�.. Indi<^.t�
phpsician or coroner address
Place of burial or removal Mt. Olive M't. (ll vmnt�c__�__Tp3iana
name ot cemetery address
Date of bui•ial Colvin and Son___ Prina�tan,—Indiana
Funeral Direclor address
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Signed
Gibson County �Health Commissioner
Oakland Citv Indiana 1�0/27
address - date
Gecoi•ded locall�• in Iwok No.-4 —_—_Paee No.��—Filed:—L1�10%�