Death Certificate - Smith, Grace V_2/10/1983RECORD OF DEATH . �
GIBSON COtiNTl DFP_�RTMENT OF AEALTH
PRiNCETON,INDIANA
TffiS IS TO CERTIFY, that our records
GRACE V. SMITH
�i/7?/75 at SPM _Gib. Gen. Hosp. Prin�tQ.n. INd.
month day year hour of death strneG hospitai, rural
Age at Death F9 Sex Fe. Color wh. Marital Status Married
pesis write wheYher married or single
Primary cause of death given was Acute myocardial infarction
Signed be Bruce Brink, DO P�inceton, Ind.
physician or coroner address
Place of burial or removal White Church Princeton, Ind.
name of cemetery address
Date of burial 3/24/75 Colvin & Son Princeton, Ind. _
Fwneral Director address
SEAL
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Gibson County Health Comm ssioner
Oakand City, Ind. 2/10/83
address
Recorded locally in book No. 9 page No. 5 �led : 3/ 31 / 7 5
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