Death Certificate - Ralph, John B_11/8/1976RECORD OF DEATH �
�
GIBSON COUNTY DEPART�IEA'T OF HEALTH
PRINCETON, INDIANA
THIS IS TO CERTIFY, that our records show JOHN B. RALPH died
Sept. 19, 196�at qPM Haubstadt, Ind.
month day yeaz hour of death street, hospital, rural
Age at Death 58 $ex Male Color white�qarital Statu� Married
}�ears write whether married or single
Primary cause of death given was ��#�#�.�+iE��i��i��#�`#�# #.�f��4.##.J�t�#.#�##l�# _ _
CoronarY Thrombosis
Signed by F. 0. Marchand. M.D. Haubstadt Ind.
physician or coroner address
Place of burial or
Sts. Peter � Paul
name of cemetery
Haubst3d
address
Date of burial 9/22/67 ;d�de Funeral Home EaubGtadt 7n�7.
Fhneral Director address
SEAL
� �/ ��%`i�!` lr. �' C �.�
Signe �
Gibson County Health Co . sioner
Oakland City, Ind.
address
Recorded ]ceally in book No. H-50 Page No.— 9� Filed: 9/21/67
date