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Death Certificate - Pickett, Charles C_12/13/1972.i � - . ��. ' � .� � '� . - � RECORD OF DE4TH ��. • � -<< . ° ,. - - �:,i .1 _,�: - - i �-•� :. 1'' �GIBSO\T�COti\TTI DEPART\lENT,OF HEAL`PH�'� .� ,.� � =- � . .- ��. ' �_ � �� � ' PRI\CETO\`- [1DIArA - -=i. - ' - � - i_ . —._ �� ' _ � .:� {�_. _ �i �-,i " ' � :THIS IS TO CERTIFl„ that our i�ecorcls ;show :+' = CAAALES-_C . PICKETT � 1 died f�' _� ; � t . � _ � _. . F. � : ,_ : : , .Dec. = 1 . 2'c. -�1972 ��at 1+l4'5PM-127 S:'Adams " Princ'eton,:' Ind. ` -- - month-�- � ��day ;� .��ear`�- ' �:houT,"of:death:. _, _ .,street;hospi[al;..rural': =_ '� ��,' . .- '� ': ' : -�'� . . • .. • '� . rlge"at Death ' 70 ,+ _'Ser! Male" ' � Coloi +•:, Flhite '� i ' MaTS1ed ' " {-. �'• ° }eats�.�� ��! --; {:'write.whether mariied'or'cingle � .� � fl� . : t. ' , � � . _ � Piimai} cause bftdeath'g�ven hvas-�gTebTal�lemO.LLY�A$8_ ` .,.. _ i= :�., _3 I. _ ' 'fi. .�. :i, . ..� � - - .. . . _ _ . . . . . _ . . : ; - . ._ --�. .: ;.. �� +- ; '.i - ,:, f - �.'< . •'"� ` ` ' _. E .' S,gned b� 'A ' E. Weitzel• t+ffl ' princEton;,Ind " °," -; ! � - " �i;phasic�an-•br coroner.' -..1; -. � , : address`,° � ' _. � Place�of buiial oi iemoval' }' C01uIDk�l�t]uT__Ch � Pr1 nce� ,�rit1 f' - � �" s: t'• ;address.,021 . � i.- .. '` ` ' - - � ' ; � : name: of cemeter} � . , � � i'„ , Dateof bui�a 12/ 72 J-"Kendall Funeral Aome � Princ ton,:jInd. ;� :: s . . �.-. - i � � � Funeral=Di�ecfor � � ; - � dd � _ � : ' ' . : � �' � -tl ' '�' '� ' 'i 1 _-.,��rj._ � .EI' SEAL�. . . _ ' "• S�gne .. .� : � ' ��7r� -_C � - � �� � � � Gibson Counti � Health Comm�ss�oner • � � � � t i ! � t � �t, � .� � � ;. .. � � . . y : �-. 4 ! �� „W � ' "�+ ' Princeton; 3rid'. _ �1•2/8/�2 - -�'- ^" , ' . , . � ,,: � � � add;ess ---; , Date � - . .'i ri ": : : .� � . . ' �" � ,.: '., � � 1' ;' . . �' � Recorded locally m�book No� $ � �page l�To- ' 62 ' Filed: ���72 ' �� � �;. " + .:� '� �' - • - - ' ` , 'i� - -. - ; - - -�,•= �•. �:... �.:.. :+ ��':�' :r c '', ' , ' , -- , •i�,- ,'. �.-.��. :i= - r i. � - �L•- , - --� - ;, : - , � � •, , �. „'" :;, � ' ~. •;_ _ - � ' � �' -=;_ t •;�:� . - - - .... ..,. , ..---� .. . . . _. . . .. _., V._. . _._ � .. _ . . .__. ..._. .a. �.,