Death Certificate - Nichols, Louise M_4/27/1979RECORD OF DEATH �
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GIBSOI�T COUNTY DEPART\4ENT OF HEALTH
PRINCETON, INDIaNA
TffiS IS TO CERTIFY, that our records show LOUISE M. NICHO .S died
11/17/77 at 7:07PM Gib. Gen.Hosp Princeton Ind
month day yeaz hour of death street, hospital, rural
Age at Death 65 Sex Fe • Color w1►• nlarital Status Married
}-ears �vrite whether married or single
Primary cause of death given was Acute Cong. heai�t failure
Signed by R. E. Weitzel, M.D. Princeton, Ind.
physician or coroner addmc_s
Place of burial or removal I.O.O.F. Princeton, Ind.
name of cemeten- address
Date of burial 11/20/7% Kendall Princeton, Ind.
Funeral Director address
SEAL
Gt� G��i �° < �.�
Signed
Gibson County Health C missioner
OaklandCity, Ind. 4/25/79
address date
Recorded locally� in book No. 9 Page No. �2 Filed: ��22�77