Death Certificate - Mathes, Denver E_12/3/1985r'��
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RECORD OF DEATA
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GIBSON COUN'PY DEPARTMENT OF HEAL1'H
PRINCETON,INDIANA
1'HIS IS TO CERTIF'1', that our records show
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Oct. 28 1985 At 11:00 A. M. Fbrest Del Nursinq Home
,. � month day year hoar of death stmet, hospital, rural
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Age at Death 66 Ce% Male Color �Vhite Nrarital Status Married
��! years write whether married or �ngle
'� � Primary cause of death given R•ac r n�.,;+h Rrain MP{'.lCtiiSlS
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• phpaician or coroner addzess
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Place of burial or removal wal n„t Hi 11 Princeton. In.
name of cemetery address
Date of burial ck-t- "�0 1985 c�lvin Princeton, In.
Flmeral Dizector address
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Gibson County Health Co 'oner
Oakland City, In. 11/185
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Recorded locally in book ATo. 10 Page No. 157 F51�
11/1/85
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date