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Death Certificate - Schafer, Kenneth_10/12/1973
. RECORD OF DEATH � _ • • _ • GIBSON COUNTY DEPARTD4EATT OF HEALTH ' � ' � - PRINCETON,-I\DIAN:1 , � . , . 1'HIS IS TO CERTIFY, that our records sho�v KENNETH W. SCHAF'EA,. SH. died Mar. 1Q, 1971 at 2AM kR #1 Princeton. Ind. � month� day year" hour-of death . � - '- street, hospital, rural . , , . Age at Death %� SeY Male= . Color - White nqarital Status . MarTied � - - _ . - years _ . � - � � � � write whether inarried or single Primary cause of death given was MqoC8Pd1�81 infarct.iop Signed by. william F?. WPlls, h1n D.._:_���Q�� ' , . - . -' '�Physician or•cotroner - . . . .. �.. a ss".- "'-'—'� --. - . .. . ... ' Place_of burial or remoyal Walnnt R�hll _ - Ft_ RrAnrh,��d . . . . .. . name�of cemetery � - - � ' " address- .. � ' - . . Date of burial 3/21/.�1 �olvin & Son ��1t� * ri; It3�. _ . . � . �� Funeral Director' ... . . . - address . - � '--- " � . . � r . . .� �1L'�_ ' ...� , � SEAL . - . , Signed ''`,`""`C/'��r������� , - . � _ � � � - G�bson Countg Heatth Comm�ssioner .- • � , Princeton,� Ind., 10/12/79 � � . . . � . addmss . . . - . . � date � '.._ .,�- . . . _ . . . Recorded -locaDy: in- book No. A_� ..Page I�TO.��_Filed:�������� •