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Death Certificate - Schultheis, Frances_8/13/1975�� "RECORD _OF DE:�TH � � � � � _. _ � GIPSO\ COliNTl DI�PAPT\II��iT OI' IIliALTH PR[ � CF,TO\,. 1\ DI -.?:;_ - '- �. TIiIS IS TO CERTIFl, tiluet oui• i•ecords slio.c__ `:T= "'=,rS ,iv�t� :;r;-�;r.?:,'=r:-; �' � ' .13Y1. Lj, �.G�j1t at j?;LL4Ji: _;,�.� .`_011fS'i :13C�' �T_i_nCP_�Ott. 71'1(?. . month , day pear � liour of death ;treel, lios�ital, tv:3l . .i .r :1gc at lleath_ 7�L Sex '�a1° Color ���?? �� _�fariial St.tus -�.^;�_ri . � � cears ' a•rite �chether married or : i, � � , Primar�� cause of death given �cas ^�TOCard�al ;n_'?_�t;�„ _ � .��.ilTlltcl V�- ' �l l i i o n, � _,�_j_„ •� _ jyt_�� •��Lf;jl � i .nr� � ' . phycici:m or cm�oner � � address -- PLicc. of buri.il or remo��al—_ `'t• 3-`=�='_'n--F�Sr,�ai__�n�_,,.a --- - nnme oC ceme[ery � - ❑i1J!�ess Date of bm•iul.._._7 % � �/^ti r : ; ! sr:�L ' ' " . i � F\menl Directm• ., , . �� � G, r_��,;�f<��;nrG. �a����.� ��.,,ne�l----- — � -- Gibson Cuiu�ty Health Cdrl�mi�sione:� _ (laL: i'1Yt.^, i.i tirt Tt1^ . ' % /'_ _ - J.; —: address ci:ri�� ; Recorded locall}� in book No._ � Page No.____'?��_Fil;;d: � '"_""�_��'— _ ,--._.� _ . _ . _. -