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Death Certificate - Schmidt, Herman_10/18/1972s RECORD OF DEaTH . � • : - - . � - ' " GIRSO\' COli\TP DF.P�RT�IENT OF HEALTH : .. . ` . ' _ . . I'RIVCETO\. I\DIA\A - �, THIS IS TO CERTIFY,.that our records show _ HERTIAN_O.._SCHMID� � y died "� Feb. 21 _ 1966 _�L 10s30AM RR 4�1 Lynnville, Ind. - �'� ' � , � month • day }•ear � ' hour of death street, hospital, rural ' � , -- - Age at Death 44 ' Sex-_. Male Color____White______b�rried ' � , � years �vrite wliether married or single � � � . � � .. - . . - . .. � .. . . . - Primar�-'cause �of death gieen «�as_Self-infl�cted_gunshot_wound-in-left-ck►est ;;.- �. - � . , � .. . ' t,,. . . ; , •_ , • . •. - . �•=•Signed b'y � BQber.�J. Wade, Coron€r-� Haubstadt,-�-nd. - ' [�. — , '. - - . - —phy-ician.or-cprener. _ _ ___ _ .-a<L!ress --- -..._ —,- . _ . _ � � . . . - _ + ..� .._- . i..: — .' Place of burial or'remo�-al_ �'�� S_t:_Matthews- � 1ti�ar-r-icl�,-�fl�-. � � . _, • name of cemeter}� - address . . . � _ ., . � . . . . . i. ' . Date of burial '' 2/24 66 _ Pem_ber.ton___ _Lynnv_i11s,—Ind. - �' � ' � � Fune�al PireMOr �' i `/ laddre5.:, � - _ . � ��' � % � SEAL . Signed!�4.(,[��._��(r� _ I � � . , " .� .- ' �'�+Gibson Cotmh' � �oner , :. -;. �. . _ _ - . Princeton.: Ind. LO�L8/_7_2—• - " ' ' ' � ' � ' • ' " address . � " � Date . - �.�: � . . .. , � . � :�..f�' :... �._ . . _ . . . .. , - Recorded•locall3:,iq,book No._Hc50: -_Pave No._$4- • Filed:--2-��$-�66 , •• _,_J . .. .' ._ ' ,. '. . . ... .. _