Death Certificate - Pavey, Melbourne Leland_1/2/1987RECORD OF DEATH •
•
GIBSO\T COUN'I`P DEPARTI'LE\tT OF HEALTH
PRINCETON, II�'DIANA
TFiIS IS TO CERTIF'Y, that our records sho�v riELBOURNE LELAND PAVEY died
Dec. 23, 1986 at 3:15 A.ri. Gibson General Hospital Princeton, In.
month day year hour of death street, hospital, rurat
Age at Death� 78 � Sex Male Color White�qarital Statu� Married
y�� '' write �cheiher married or su:gle
Primary cause of deain given �eas_ ('PrabrocaGC�nlar ArridPnt
i�run �
$igned br
nLLICILi1� r1.L.
phpsician or coroner
nrince±on; in.
address
Place of burial or remo�•a1 Maole Hill Princeton In.
name of cemetery address
Date of buriat December 26 1986 Colvin Princeton, In. _
� Fhneral Director ' . address �
SE aL
� s;�� �i ,y�,�'�o .��
^ Gibson County Health Com sioaer
Oakland City, In. January 2, 1987
address ��e
Recorded locally in book No. 11 Page \�o. 30 Filed: December 31 , 1986