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Death Certificate - Stoll, Charles F_4/14/1972_ � , i , , , ; :i: � . . ;' � " :;C: , t +�.. �. .'� �- . _ �. i t= �.�. �E —, � � _ ""' .; . .. •.. 1 —_ � t. � � ,i. ' . � . � . RECORD OF DE�1TH i�: 1..'� ". I —� � c - . t::� �.:i: � ' GIBSO\ COti\Tl�'DEPART�fE\T OF AE�1LTfi'� " � 'i"�� ' ` - � - - - 1 _ � � " j., �' ,�. �PRINGETO\, INDIiCAAI..� . � � . !� .i..,..� .��: � - � ', ! 1'•• i�' ' �r �. .. , �1 ' "� � . �' . � : � f. 3 ,.:�.` , -THIS'IS�TO•CERTIFY,:that•our'i•ecord's sho« CHA�iLES'F. jSTOL� -�' ' •�' • died:'': -- � � , • � - — , _ , : . , ':, - + _- , ..^ _, � �- , . • April :. i; 8�� ,�12%2 e.. �'at 2.�;�5PL 'SoVL�E.-Hrr,ar�wu� Princetoa;-l^dE� ,:,.- _ month_� _ .:da} �` _:�� -�ear • _!:�'.hour�ofdeath- .;'. _ _ '.street',hospital;rural _' '; A�e at Death': 6i ' -Se� Flale� �=�Color :' =5lhite i_= =14aTTied-, 1 . . �_ ' � , ` ' years, ; - Y � " ' � ""' �' "' : } `.' = ;w•rite «�hether'maiTied or: single - � � � _' . . .�. . :t: '.�' . .i. .�. . �. . ' _ . - ' ' - ' �'- Piimar} cause of death•'given wa$ '; -' 'My_nG3Td1A1� Infarr.fi}_p� ' .� .�. � . . { .1. .S. ]� !� " iIC :1 .1�" .i�� � �� - -� — 1 ' � �.� - .- _ I �. . . .1. ,''+ .'i' �' ,5.�.- '�� �� i. " ' Signed by =�' _ �'James=�F:_P�.4k� � Mfl - Prinrnfinn�. TnR; -� - - -`�' _. � � �-' • : � : i physician or. comner.: � '' -' � " "� ( :. addmss �� � ' ' " i - - `, . : .. , . , i, . _ • . - - _ , , , Place,of bunal oi removal � �� - MAn� P Hi � l �� PTS Y1�ptne_oon ��_i�}�• ' �.• � ''^-�,�` -�name�of�cemeten ;j� a� • address-Ij � .�� ; �-�i. , Date:of bunal .4/.1.0/.72 �', � Cololn & S on ' � . 1�~ I � � d - � r � ' � ' i : . .i� , ;�.,, . - - .� , � -•- •__. �i, - 1 �,'Funeml Director . � a � � .^„ . � . �r�.�� e�t iY .� .� �i �4' _ : �: ` ,. � " ' i � , ��.SEAL. `-•� � ? .�� ., - $�gned ' . . j�'.CC.�t.�i�'A -' , _.. - � . `t�: � � � i . . �: t . _ : � �. . � , : G�bson County �Health Comm�ssionez � _ � : - . . - � � ' ... y'� .i_'. ' - i,_ . �.ff �. l; , �:._' . .� r .� : � 1 �� � `"•':. .. -� ' ' :Princeton�.'.�ind. � '� •�.':4%1�4/�2 '.:.`; -- t � � � .� �.� �', �. ,.• �-� -� '� �.! ' f. � .� . _address+�;: ' - , ` ��t: ,i::. - . Date'�"i'l :_. �- ;.;. ;� .. ,'_ � _. 1 , . 4 j � .: �.. ,:Reco�ded locally m Uook:No '°8;, . Page No � 4fi = F�led: 4/i'�/_7� _ �' ,� =i�.�f ' - � ^v'= - =� !�- � . �._.. i :_ - � ii '. � ;� . _ . — � - • — . " �{.� � � -�'. t ` � . . ii � - n �.f.C� 'i + . ' � .�� . � ' I . J f ..: - � ' . 1 1 fy;.yl . t1 � , � '_ _ .� t, �� '. . '. ` 1. . �"! ' .� �i:•l . ' �� t �'•:' .1. �� � . � . . ��. ` . _ � � �. I �). . �s• t � 1 ' ', . '� � .. ..• i.�.�..'i�.��. _ :1 . � _ .I _ �. . . �.��`. .1 .. ��� i.-..t � . . . •. «�ri • � 11 1 •1 .t�.• . . •. . �.. . . • . . . , ..• ,