Death Certificate - Peavler, Charles William_4/24/1992!�,
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GIESON COtiVTY DGP:1P�TlILNT OP HEP,LTH
�"'� PRINCETON, I\DIa\,1
THIS IS TO CERTIFY, that our records show '%�a'��:% :'iI i�L=:�iri t�� �VL�i� died
. '':�:% 7> 1C%(8t _ �05'::" 1=Y'l:;l :05�. tica.ti�?tL1 ;ii,,Yr li1<�.
�� month � day vear hour of death strcet, hospital, rural
5c �;�a.l� :�'h; �.� f�'ar:iee
Age at Death Se� Color-- �farital Status
.. years write �chether married or single
Primary cause of deatli o c•en �eas :?e�' �'-�' � � ' 1:' "E' : p` ° `'.3:;,�i � `' "; ,-ri no;:,� � s � ; ,.� r
.v. ^ li l�Yl�. 7� ('..l:l-nna (`i_'•,r T.,.: --_
�-, si;nea ty -9_E_= —
-� phpsician or coroner address
Place of buriai or remo�-s1 = • �' . C� . ^ . ?ranci�:co , � r.d .
name oC cemeterp address
Date of bui•ial_--�1r7 �orn ::ior-�u��1 � G�,!:��n� ';i ��, Tn.9.
F4ineral Director address
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�'i C�i=� G. � � < �,D
Signed
Gibson County Health Comm�ssioner
oaiclar.d �it;;�, �;,d. 5/?�/%7
address date
P.ecorded locally in book \o. "'-- r"-' paee No.—��' Filed: [�°�77
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APR 2 41992
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