Death Certificate - Simmons, Laura Marie_4/26/1978RECORD OI' llr:ATH • •
GIBSON COUNTY DEPART�4�NT OF HEALTIi
F'RINCF.TON, INU1:11A
THIS IS TO CERTIFY, that our records show I�AURA A7ARIE SIMMONS d���
4�22�197$ a+ Z:OSAM Gib. Gen. Hosp. Princeton, Ind.
month daY year hour of death street, hospital, rurel
6 Fe . Color �' hSarital Statu� Married
Age at Death� 3 Sev write whether married or single
yeara
Primary cause of death given was Massive cerebrovascula r accident
Signed by
- Place of burial or
� Date of buriaL
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- t/ �
'- SEAL
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;,r;;, F r��ro, nrt,n. Oakland
physician or coroner
removal l^lalnut Hi11s _
name of cemetery
!�/24/j8 Corn Mortuary
F�neral Director
ity. Ind. _
address
Petersburg, Ind.� _
address
9akland,City, Ind.
addzess
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G✓ GL�I� L�r / n/ �/ '
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� Gibson County Health Commissioner
Oakland City, Ind• �/26/78
address date
Fecordeil locally in lwok Iv'o. , 9 Page No. 62 Filed:�26 78
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