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Death Certificate - Smith, Elmer_4/12/1973. .. -.� .`. . 1. . - �.t. . . � .� .� `�^`� .. .� � . ' . ., .. . . •. . + . . : ' � _ . r . . _' 1 . �..- t. .�• .�.- ` . . - Y . RECORD•OF� DEaT1i �; `. ' • • ` � i' .'+ -.� - - � "' , ' � ! '�- . �. ;. �_ •.GIBSO\�COliNTI�DEPt1RTDIE\TT OF-HF.AL'I'H'W .!1�: . , ,a : _ �. , ��, ..' ' PRI\CETO\ IND[A\A _ � .: � `' �' 4 — -i . .i� �� .i ! � i�. i..�..•':, � THIS�IS TO CERTIFly,! that oui reco�ds siiow EL'M�.B_SMITH- ' ' ` ' died �. - .,� j. .. �,; ,� � , ,. , ��jr - - ..= . ,r_ � t 7 � � en:_Hosp. -Pr-incetun,-lndaana�Y == ,- /26/67' - at G;ib G - ..month ; .� day � � }ear "hour.of'death� � : - _ � . ' street, hosp�tal ^rurel , . _ � !-�• -. ' 1 :,� •)1� � ,",.:. , C,.� .... .� .r - - " rlge''at Death '—�"�`-_.Sex Male ` � Colo'i�J�te � ! rlarFiec� " " "' _ . � - y ears . � - ': �vrite �rhether' married :or . single � ' � i'� . ::, � - . i ,�� . .:;t ,:._ . ,f . �.��.. . .�;' . .,.. ,.� . . s r+ . , •Primary ,cause: bf death g�ven �"vas_—!�!�L4��Ldia1�1111I�2 "= � �' ` '. . �_ �,_ o. :E�. _t' ^,� . - � -- ^:�� t ��i - °' %'-� -. -; � � : � � - :'� � .- ' " �� . .�ti � • i . - '�, - •+� .,�� - � -�._:i �Signeil b� �B� �. B'rink ,D;O ,� Brincetog, Ind�tla" � -_ ' _ — •.�.• i` �.�� .^ph}stciari�oc�coroner� . ~� t� .��. ! '�.�address,' - � „�� Place�of burial.or remo��al P3toka Cemetary Patok3��ndiana �'= _- . . _ �' ? ' name of_cemetery-. � address, . �� . �, . . , . ': . � ' _. � : ` _. .'_.,. . �: ;�_ .-�� , � . �t - a..�^ Date�bf bw�aL,7_L26/5�7 •.Co'lv,�&_Son ? � •Princeton nd�ana �- '`' - •_ •-••~� :Fiineral'.Dirnctor. � ' ;�` .� �- - :�- '� i��:) il��j� .. ` r ._ ._ '.'. " 1 YY. � ;..SE�L � R F�X;`�� j , - S�,�ea - . ' .I�� ' t;- - —'"� • _ ' 1.:' � ;�.-. .Gib u �=� �... '' �y . ' . �� ' '� ." . �t� - h, r,�-' "� 'i 3 , Princeton, Indiana `'- 4/-12/73=�{- - — T \1 . � - ��. .li.- .1� { -f,. - . � , �:. � ;� � - � - � - address' -� - ' i' Date : ' ' .� r '� . .. ,' . ; .- '. .C'_ ' ��. -. • � �" ' �� r:. � . f�1vf :, _.. :... .. . l .�..' ' � Recorded locallc in book ?�TO 7� , �page No:�'S1--Filed:__-7_�3'_�/�� _, _ � � „ ^ .a. .�'�.: � - - - � � �^;�j�ii� .::. - .� ' �. ' . - c-.; � !,., �� ^'��e�\1S .�• ..�, ,� . �.. 1 •• . 1, .. _ i ..�4, _ ' , '_- �..'� . _ ';i , - . . i... . . . . . �- 1 =� . .- - � ` � i ' ' • - � { i' . � 1 � . tl� �. �j � _ �.�.� � � i i _ � - - - � - -� - - .. . - - - -- t: . . . . _ .. � - . - . . . _.s_._ . . �.�.� �� . , - .