Death Certificate - Peck, Mary Evelyn_9/15/1975RECORD OF DEATH o �
GIBSOAT COti?�"I'I' DEPARTIIIEI�TT OF HEALTH
PRI V CETO�'. I\ DIANA
THIS IS TO CERTIFY, that our records sho« I'fAEY EVELYN PECK d��
Dec. 13, 1974 at 1PM Outer W. Monroe Princeton, Znd.
month day peaz hour of death street, hospital, rural
Age at Death 5� Sex Female Coloi• White �qarital Status Mn�t nA
years write �chether married or single
Primary cause of death gicen wac Smsll intestioT�l obatruCtlon
Signed by A. S. Me$lrov. M.D. Princeton, Zn�i.
� physician or coroner address
�
Place of burial or removat Walnut Hill Prineeten� Ind.
name of cemetery address
Date of burial 12�15/74 Colvtn g� Rnn p�.��8e�����
Flineral Director address
SEAL
� �i�¢�i"'/ G � �' I < �.0
$igne �
Gibson County Health C missioner
Oakland CSty, Ind. 9/19/75
address date
Recorded locallp in book No. 8 Page No. 108 Filed: 12/1�/�4