Death Certificate - Peed, Charles W_4/14/1976; / . .. -� -- - - - - - --- -
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, RECORD OF DEATH „ -
GIBSON COUATTY' DEPART\IE\TT OF IIFALTII
PRINCETOV, I\DIANa ' -
THIS IS TO CERTIFY, tl�at oui• recoi•ds sho��� CEiARL.c.S W. p�ED died ,
I�;' May 15, 19�5 at 8i15Fh1 _ Gib. Gen. Hosp. Princeton, Ind.
� imonth day year hour of death street, hospital, rural �� �.
Agz at Death 58 Sex t!ale Color �� hl_��—➢fai•ital Status Married
years write µ�hether married or single - _' �
Primarp. cnuse of death gi��en was Acute Mvocardlal IpP�ction
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�;o,,,,,� �,,, Bruce Brink, D. G. Princeton, Ind. __1�
physician or cormier address ' �
Plcue of bw•ial m� i•emoval ldsrnock _ PT�nceton_� Ind.
name of cemetery• address
DatcofUurial_ 5/19/75 Colv1.n � .SOri—PTj,n�Qto�t� In�.
Funeral Director address '
. �4.(.0 �� � � � �:
SEAL Signed
Gibson County Health Commissioner "
Princeton, Ind. 5/27/75 �
� address . date
'. Recorded locally� in book ?�To. 9 _Paee No. 8 Filed:_5�z7�75