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Death Certificate - Ridley, Hilton_8/27/1974�. � -- - -_- __ - ._ - _:- _ -^- ._ = --�--a = - _--:�-1 RECORD OF DE�,TF�'�. �- _ ti. ., _ . :..' .. -___ _ ��_� ! � `..CIBSON COliD1'TY- DEPART3IENT. OF HEALTH �� _ _ . ' � - � - � . PRINCETON I�IDI_a;IA ' - - '..�I � •� `1.�-r �jC�=.2oA � � -- = . __ - . ., . .. _ - t = �_--` -) ,. ,.. , . --. ...... ; _�.-._....,. _ i�3?S IS TO CEE2TIF'Y that our records show ?ILiON-�TDL�'�' - died`T-� -_ i"-;� 31,--2973 �t 11°i�20PM � Gib :CPn �osp. .Prire=ton =.-I^d. -- �oniS day.- year hourof� d th---o . � - s -:-�:;:s+x�et, hosp�tal.:rural�-„ �---. � - .— -i .. . - . -;. . iY. �-, � _. , tc ��-i7. ' � �.. . =+.�r � x. ' �t tt .. 'i:.�:;.:_'"_ ., e_._.�__ ' 1_._ �ge: at Drzth �--71 4ar Mal �, Color ^ Taht tP •; civlantal �Status raar f i od -- 's.= -.�:. � i 9� i- ''�yt +�a '�t s - wntewhelher.mamed or-smgle;�i S . it..,�.. . ..:.� i i. tI :...Ir k �,r .nj5,r.��i+i�.�r. ..._ .. � ..� � .-� ..T.=� . . .�. r iF:. �Pnmary.cause:ofileath:�given.:Waa .?•_.Arteri°o�rle ^oti �ear�? dis=�se.'-' � = ---t ' ' , ;.�' : � ' � � t � �' } = , ;_ _ -- --_ �. �_- _ �.� � ' ,,. �';_�' �Signed bv James-:�F.-_Peck, :�d.D._ � �t �- � _ Prir.c>tan,:Ind.� _ _ t� , . . . . � . : ..PhY�eaan ar.;rnmner _ �.- � '+ � .=--' �'__.. -: aadress-:...: � - - � , � .,.. � �.r. � Y,.... - . � _.._. � � . _--. . . .. .... ... _. � ._ - __ __ ._. ._..- - .. . .. ..... . . ..... . .::..,.. ... .. - -, � .:.._._. . . :. .. ��-� . . . .. Piace of burial�orremovat • - �--- Rasedale:c::�_: Lanson.:S�r.i?u3s, K.p _::_ - • _ - ;':; �,�- . name_of:ttmetery_'_ .Y,! - ----. address _ _ ' - _"�'.'�. � � � ' I. ... -.� - - . - -_- . � .: .� ��. . . . .: . ° � - Date of 'ouri�3/73 r�3�sh�a FunaraT-?ome r Da;ason Spr1nR� {y� - .-^,-�:j � F�neral �D�mctor ` :: :' ": . - addrnsq ' .. � � � . \��- ��'r I ,�� . ' - . .. � - ' -- - . ' _ _�._ � . __ 1 _ _ - � � � �_ S�AL : - ._ ,� :..= Signed--�� "��"��t��'L �� J - - - .� .. . _ _ .. - - - -. . - - - ",:-� , � � `- �- _ . Gibson. Connty Health Commissioner. .__ . . __ : � . . . . . . � ; . . . , _ . ; = ?rirceton-.- Tnd. -- -�5/1',/73 � I ° � -.- _ . - . ° t- �-'- � � •'- � address . . ..__ _ -"..:'f " :'��1 ., .� �, � � .:-_. �date• - _ ... , . - �� __�. ; , . '_2ecorded locally' �in��book-No_ --� -- �page�No_- %%- �F�iea. - 5/4/'73 - - =- - � - — - -- - — _ .. _ , --�- _ - ; � :,. : _ :; - - - - .,. 'a. '` - -.i - - 7 - . � .,, , ..__,. _ _ . . . ` .- i ,f:. . �.. _ . . - . .. : ... ._ . _ . ., _ . . _ _ . ' . .._ - i . ' . ;� � .� .. .,.. ....�;�.._.... .- �... .rr— .............._.. 1.:.��.�.�_.i_ _..-......:. _'.. . ....,...�___ ._..�..:�.__ _,.w�._�..�._t. .. v__. ...�.i ,�-