Death Certificate - Mason, Goldie Pearl_8/21/1984RECORD OF DEATH �
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GIBSON COliNTY DEPART111ENT OF HEALTH
PRINCETON, INDIAI�TA
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TffiS IS TO CERTIFY, that our records show GOLDIE PEARL MASOr1 died
12/11/40 at hi. E. Hosp. Princeton Ind.
month day year hour of death street, hospital, runl
Age at Death 37 Ses Fe • Color �'jh • Marital Status Married
yeaxs write whether married or �ngle
Primary cause of death given was— "ephritis; Toxic pregnacey
Signed by 0. T. Brazelton, MD Princeton, Ind.
physician or coroner address
Place of burial or removal B1��+hP h3� A� Ft Aranch, Sn�1
name of cemetery address
Date of burial 12 / 13 / 4 0
Flineral Director
SEAL �
Joseph Laib
Ft. Branch, Ind.
addrnss
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Gibson County Health Commiasionex
Oakland City, Ind. 8/15/84
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Recorded locally in book No. 5 page No. 4 2 ��� : 1/ 31 / 41