Death Certificate - Peach, Gracie Mae_12/2/1986�r /� n
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/���r� „ GIBSOI�T COjiI`TTY" DEPAR'I'I�1ENT OF HEALTH �
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THIS IS TO CEP.TIFI: tlia't our record� 5}lOR' rRA('TF MAF pFACH died
�ov=mber 8,1986 at 8:05 A.M. R.R.�,�r 1 Owensville, In.
moneh da5 year, hour of death _ street, hospitai, rural � _
gp Female White � i4ido�ved
:1ge at Death Sex Color 'D4arital Status
years `' ? �v�'ite �che[her married or single
Primarv cause of death �iven �vns_ Cardiac Arrest; Atherosclerotic Heart Disease.
_ � J. .- =_' �� E. Hendrix, Jr. ,M.D
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phcsic:an or coroner
Place of hurial or remocal `=aumee
name of cemeterg
Dateofburial„°vember 11, 1986 Holder's
"!-� � • :-_. _,s� F4�neral Director
Vincennes, In _
address
O�oensville, In.
address
Ocaensville, In.
address
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:SEAL• ' ' -,, Signed
� yiti - _ -- -- . Gibson County Health Com sioner
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� Oakland City In. �'ovember 17, 1986
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� . � , � � address • � ��
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� November 17 1986
' ?;ecorded locallc in book \'o. 11 Page No. 2� Filed:
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