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Death Certificate - Pauley, Clarence E_8/22/1978.�...rr _ . _ . . .. " J
RECORD OF DEATH . �
GIBSON COUNTY DEPARTII�NT OF HEALTH
PRINCETON, INDIANA
THIS IS TO CERTIFY, that our records ahow—�T aRFN('F PAULFY —died
8/11/%8 A+ 9+40AM Gib. Gen.Hosp. Princeton. Ind.
month day year hwr of deat� etreet, hoapital, rural ;
70 � M. ��or �• Marital Statuc Married
Age St DeSth eR wr(tR whether merried ax eingle
yeare '
Primary cause of death given was Myocardial Infarction
Signed by James F. Peck, M.D. Princeton, Ind.
phy�cian or coroner address
Tabor RR Haubstadt, Irri.
Place of burial or remova address
name of cemetery
Dateofburi 8�i3�78 Colvin Funeral Home Princeton, Ind.
Flineral Dirntor ' address ..
G� U�� � `'��'
SEAL S1$II
Gibson County Health Commia9ioner
Oakland City, Ind. 8/18/78
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j � W�EOO �
I pa e No 68 8/18/78
Recorded locally in book No 9 S �I�:
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