Death Certificate - Miley, Imal_6/6/1978.
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RECORD OF DEATH
GIBSON COUNTY DEPARTMENT OF HEALTH
PRINCETON,INDIANA � �
THIS IS TO C�RTIFY, that our records show I� MIZEY diecl
S�Z��78 at 11PM Gib. Gen.Hosp. Princeton:Ind.
month day year hour of death street, hospital, rural �
Age at Death 65 Sex M• Color Wh. Marital Status Married
years write whether married or single
Primary cause of death given was--Myo�ardial infarction
Signed by Wm. R. Wells, M.D. Princeton, Ind.
phpsician or coronei• addmss
Place of bui•ial or removal Atkin�nn C'hagpl Oatsville, Ind
name of cem^_tery address �
Datc of burial �27�78 KPndall Princeton, Ir.d.
Fiineral Director address
SEAL
� G��.:ei'L � � �-,,,c � ,�,i.1j
sigaea �
Gibson County Health Co missioner �"
Oakland City, Ind. 6/1/78
address date
P.ecorded locally in boolc No. 9 Page No. 6� Fs�efl: 5�31�7$
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