Death Certificate - Maxey, Lillie G_6/5/1987RGCORD OF DEATA .
�
GIBSON COUNTY DEPARTIIENT OF HEALTH
PRINCETON, INDIANA
THIS IS TO CERTIFY, that our records
LILLIE G. MAXEY
Seotember 8,1986at 10:55 A.M. Goo3 Samaritian Home Oakland City In
month dey yeer , hour of death street, hospital,�rural
Age at Death 95 ' Se� Female Color White Dlarital Status S�idowed
peers a�rite u�hether mamed or single
Primary cause of death gicen was Cerebral Vascular Accident ( 4 hrs .)
i�rteriosclerotic Vascular Disease ( 20 yrs.) Rena1 Failure.
Sio edby �dilliam E. Dve, hi.D. Oakland Citv In
� " ph��sicic:n or coroner adires;
- Place c. bu.ial o: ,-emoi�al rlontgomery Oakland City, In.
name of cemetery address
Daceofburia��eptember 11, 1986 Lamb iledqes & Basham 3fem. Chpl. Oakland City
Funeral Director eddress In
�EcV.
Signed 5�4� �`�./ ''"�'8� � u�Z'.�S%�
Gibson Countp Health Comrrti. sioner
Oakland City, In. hiarch 10, 1987
address , date
Recorded locally in book \�o. 11 Page No. 22 Filed: Seotember 18 , 1986