Death Certificate - Martin, Mary Jane_12/10/1987RECORD OF DEATH
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GiBSON COUNTY DEPARTMENT OF HEALTH
PRINCETON,I:7DIAYA
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THIS IS TO CERTIFY, that our records show MARY JANE MARTIN died
July 26,_ 9R7 at Anomx.� 2c00_�M_ 507 F._ ['l,irk RY_ Owansvilla, in_
month dny year hour of deeth aVce4 hospitel, runl .
Age at Death 5�6 Sez x�eroa i e Color � t,ih i tP Alarital Status Ma r,ripA
yenn .vrite dhe�her merried or sir.R�e
Primary cause of death g'ven was Acvte M�ocardi al rn farrt i nn
$Ignedby Rit�hnrd �n_ Hinkmd—C'nrnnar f:ihcnn C'rnmt3/ prinr-atnn, Tn_ _
' pnssivien or romner _ euartss
'. Place of burial or removal Benson Owensville, � In.
.. neme of cemetery nddreea
Dateofburial July 28, 1987 Holder's Funeral Home, Inc. Qwensville, In.
� , . Funenl Dirtc�m � eddresa � .
SEAL
signea f/!/"f'/ `�r.''!� � .�; ,aD
� f.{byon Caunty Health Co mner
Oakland City, In. Auqust 3, 1987
eddress � de�c
Recorded locally in book \o. 7 1 Page No. d 3 Filed��>>.��____? �� gg7
RECORDED TFII9� nAY OF � k' , 19� AT9= �� -
/.�II . �� HECORDER GIBSON COUNTY. INDIANA
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