Death Certificate - Pauley, Henry Oscar_2/1/1972"RECORD OF DEaTH
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GIFSON COli\TI" DEPAFT\IF.,\T OF IIF,9LTH
PRINCETO\, 1\DIA\A
THIS IS TO CF.RTIFY, that ow• records sho�v =3^i�RY OSCI�F. FAUi,L:Y - died
Aug. 2� 19_59 at2PM Gib. Gen. fioso. Prirceton, Ind.- '
month day cear hour of death s[reet, hospital, �vral
Age at Death-7� Sex ?•"ale Color l•:hite Married
� y-ears �crite �chether married or �ingle
Primary cause of death gicen was Acute ?-?eart Fai17z�2____ ___ __
Signed bc R. S. r�r.,i-roy_,�.m Frinceton, Ind. _
__ . . _ Ph}_sician or coroner - — - - -. nd�r?;;'- -- ._- ..,
� Place of burial or removal D=cker Chapel RR ___P�toka , Ind.
name ot ceretery� address -- .
Date of bu�,al?'! 1 h!ri ht P� K°r.dail Yrince on, Ind. '
iF�neral Director ac ess
\\ SF.AL� Signed� � �- � �
�� � - � ' Gibson Countp Health Commissioner
=�� " Princeton, Ind. 2/1/�2-
� �- address Date
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liecorded locally in liook I�o. � Page No.�P2—Filed: g�31�-9
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