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Death Certificate - Schafer, Nancy E_10/6/1966_ , ; , . � : : ''. ' - . RECORD OF DEATH � , . . �' ` " . GIESO\T COtiNTT DEPARTD'IENT OF�HE9LTH • � . . , .. . � ..PRI\CETON, INDIANA_' • .. -. . . . . . .. . . . , �. ' . . . . - . : . . ," - � � : . � . : .Ca ' THIS IS TO CERTIFl, tliat oui records sho« �1E�r -�� d�� _ i _ . .. . : . . �'. ,�,��,� � � .�/ . �L�11�� s�� ... '�H�at %D' �L SAYI� �.u..Ge:..� -c[e 'Q /Xs-a_� (��..-:v-� � - , montti ' - da� � . _ � - year . - hour of death ' �. . � .. '� street; ospital, rural Age at Death—Z�_Set ��Color-,td�-�" " .' � ' � ' ' . - • cears � � _ . - � � � . ' : " �erite �chether married�or.�ingle�� - ' � • . Primaiy cause ;of death gn en �cas . ��-�-�-�u.--- //�,.5��-� ; . . . _ .. : Signed b�=. �� . �T.Q ° ._ ..� _ ` ��_:=�+-3.�='�.a.-w.�. - '. `` - .. � � ' � . ;.phpsi n.or coroner . .- , _ ddress � � . � _ r,�- a. � ,� . .' � / . . . Plac'e of burial or iemoval F.� � ��-� =r- �r-� ` -J , ---•� • � � � • . � � , name of cemeterp -� . ' . : , �-addres , � � � , � . • � ._ �.,�_-�,��. 9�-, Date of buiial'� �5�-ti/�___�� 'o�� : �� L ` _,_ . ' '. . . ' � ` � ..f�n 1 irector � �. / �j� . . addre_=s/ � ..� SEAL : , c.�.� .3-2s G6 ' Signed� �� t'-4tc�.rq . � —.�. . � . ' ' - .r' . � • � . � Gibson County Health�Comm�s-ioner . .7 : •. .. • : .. . �. .�`2. . � . . . �. - .Li%I.� �r'� �� /O°f"/� , � �' . . .. . . . . . . - addiess � � _ � - � , � .. � date .. . . �` ' ! � . � . ._ " ' - '. � Recorded lceally in ,book \*o �_ �� 7 � Page No. � 3 � ' � - . _ - . .. . , . _ . . :