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Death Certificate - Peck, James Frank_4/15/1983i�:COKll OE DEATH • �
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GIB�ON COUr'T)' DEPAI:TAiI:NT OF III:ALTI]
• rt�i�cr:TOn, �nni.av,�
!II$ 1$ TO CERTIF7', that our records shoµ• JAd�'E;; FRP.?�iK YEC•I'
i/6/82 at 4:05Pi�9 Gib _ Gen. Hos�. Princetor., 7nd.
:nonth day year hour of death strcet, hospital, rural
F�e at Death 59 Sex 1i2� e Color'�''Ri'.� �farital Status Pr�arried
years write ahether married w eingle
rimary cause of death given �•as ?esDiratorv i2�lure;�evere q;�?�rn�
�.-ned b�� ltiillizm R. t^lells. t•k,n. �nce�o_r.?nd..
� physician or coroner addresc
?ace of burial or remo�•at k'alnuti Nill P_t_, R�a�h, Tnd.
name of cemeten• addre=s
aie of burial ��9�82 Colvzr. Funeral I-tome p��nC_e_t_411,?r.d_. _
� . F�neral Direuor address
�
; ,SEAL
ccorded,locally in book N
10
G� ��I� �° �� , �.v
Ginson Cnuntc Health Commissioner
Oahland-CitY, Ind. 8/13/E2
aaares� aa�
No. 72 Ftiled:�f_l�f$2 —
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