Death Certificate - Riley, Edison_10/11/1977r�� �-:
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RECORD OF DEATH
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GIBSO\� COUNTY DEPARTn4ENT OF HEALTH
PRINCETO\,INDIaNA
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THIS IS TO.CERTIFY, that our records show �ITI,EY EDISON RILEY died
11/14/1973 at 4:30PM RR #1 Owensville, Ind.
month day pear hour of death street, hospital, rural
- 62 �eX Ma1e Color �1t�iarital Statua Married
Ag0 at Death write whether married or single
yeara .
Primarp cause of death given �vas
Gunshot wound to�•head
Signed by Robert D. Kendall, Coroner Princeton Ind.
physician or coroDer address
Place of Uurial or removal Cope Byrdstown, Tenn.
name of cemeter}� address �
Date of ' ' •��•' �^^ Holder Funeral Home Owensville IHid
Director
address
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C A/
SEAL Signe
Gibson County Health Co missioner
Oakland City, Ind. 10�11�77
address date
H-51 _Pa e No.— ! —Filed: 11�20/73
P,ecorded locall�• in book No. S
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