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Death Certificate - Smith, Earl R_7/12/1974d � � � > � TI . y`.�' " :�:[ F� ��.- � Pnma: '`.4'J'�!.. �.�1:�..��T� ^.�,�i'+M� �`.•` trf. _ ' ( ' .. t -'ryt ).�.e.�dial i• t . rr � � . w ov � � , a: ,. .� ��: ,� �, . !.�� DEATH , : ," .. �.�. t�• � : . f� i, , �. . .; `,; �'f� . GIBSOA COUN7?Y DEPART,IIEN'P OF HEALTI3'�.<E��; �� '- �� o . +'- f �.�PRIVCETO?I, INDIANA � :.:'P'; S� ' .3 ,� , . � � . � lic:r 4.. ' - .i . ... ' ,� �� � 9 ERTIFY that�nur records show'__ Y:'''°�' FART;�•R 'Gp�TTH �'" ' t ' V4 � i, �--�-��pp� � Gib. Gen Hosn Prince � �, Year hour of death . i t ( � t „ : street� hos �tal, � i.t��-.s .1.'S??44�..f �.+,<.i« .:faL.�'; '.g ' "" ._.i:, �.i� mu �.. ::p 4PUL3�'..IY.-. � u.� f i �- j� ' ` � Ylace of tiunaiYor`rren " a,� s � t s"2 }� : ��t� r `I +:�.iti a.`R `1 " � � , Date of bunal r %/ �i (H�� M1 4 �` ,Yk� , t i!"±;Yir��4. (�r•I + 1 f �}�i41' F'�1' 4SJfII_ � �x� LF .: . J. �. a ' � � � � c r n �� t.�l� �� e �S� 1 .� .�'�"'�l t ��tiy�`4 �. , �SEAL "t �, Y sR-+ t9 �iSY ��� 4� ii.. . 1 2 �• , ` �} � � � ra r+ . � ' � n �di'� - y� �i�- / �rs �f t �t pct` r � �. : . k �YS � � � ✓ �?�Qe v . . t' ', � 5. f-� TiQC01Y12(17 ]OC3ll)T�lll , bl � �'n� . I ��},. � � y�.Y�� � ti.! t s' 1 - I , fFyfi��'�`t PT-raa.{�7.µ�Tp� f .H. � �:�. i .. }.Y�T� R...TAS : _ . ,. ,I>� t . �i'J ; . 1'L i� `:i -'-J. . . . . .r �: .. �..� ' f . ` - � � , � , � ., � �j � °'T 1� en wac Ar eries l'Aro i��hear�seaF • ' 1� *1� } _ 4�.. "f i ' � - .. . � �`....�.Gy _��� � ..t . , .` 1 . .� . � � I i:1 � _ 1 F.s Pack `'-M' D S i'.� � r f4, ,'� ,�. �ic�anjorcotoner`'. ��-et�r� �TnB �- . . r � ,,. _ � - . ; +� �; ; . addresayy, � � " " � +��� B *f]P7 � � .- � � �j' `! �`:i � �°II3v111_�a�?'�T_nrl '' ;name of.cemeterv =� ,� � : �a - � . address . f� �` -'- " -�.. �e . - °Ho2dercFuneral�, Home : 'f � � :Ftineral �Director. � • �dress � � `- � . l ,'�! � • i.:• � t . r ..i� t •;-� 1 � rf - '� 4 � f . j � l . 4 � � '� � s ��� 'T c . '� � � � - .� ��� i . .. : �. � � , r , . + � :, ,4 �' r 'Signed ` . � � ° � � , , . Gibson�.,County sHeal v�} , j' >•, � Prinaetnn <, � ' � , . . .,.�Ind. ; � ::,. 5. , t s,_ , . addre's's � .� � . . 1 �.j; i.. , 8. ., : . ,- . , , _. .�. • Page No_l._9�Filed 7._,_/1�/�4 �� T} ^� . S�a /. i �i � s � J. 1 � �l � ° � .. 1 �. " � � >� � � �. C � � �_ �., �L f i � e � .r > i.�� r . , •�� „ + �� � �' ; N�5 f ._ �..� �:_L . SI!}�.1� y� .�Li..;CA..i� L�+.+� Y..-�' r>5_._...:.:l.+1� � _?,.. ^af) :_e.:.:i. h�=t 0 c �•-,yt F� ! :��