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Death Certificate - Patterson, Daisy E_5/30/1975� � , �
_, �
RECORD OF DEATH �
GIESON COli\TTY DEPART\fENT OI' HI;ALTH
PRINCETO\', I\•DIaVA - • ,
TffiS IS TO CERTIFY, t]iat oui• i•ecoi•ds slio��� DAISY E. PATT^C?SO�
died
May 8, 1958 ,lt 11,3oPr _ 325 ri. Bro?,m Princeton. Ind.
mon[h day yyear hour of death street, hospital, n�ral
:1ge at Death 6? Sex Fe�le _Coloi• Wht .�_T,Iarital Status
. pears
write a-hether married or single
(Primar,y cause of death given tva.L Gastric u1Cer with hemorTha¢e
I
t
Signed by James F. Peck. T!.D PrinePt2n Tnd. �
. ph}�sician or cormier addmss
Place of burial or removal I.O.O.F. Prin�eton, Ind.
� name of cemetery address
Dnteofburial__�L_1/68 Colvin & Son __ Frinceton�Ind,
. Funeral Directur nddress
SEAL
����,��� °��,�
Gibson Coimh- Fiealth Commissioncr
Frinceton, Ittd. 4/18/75
address date � �
IPecorded locally in lwok ATO.__7. Page \'o.___�� Filed:�/1�L(8
1
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