Death Certificate - Schafer, Nicholas J_1/2/19851; ,�
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! RECOItD Ol� DEATH
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� G113SON l",OUN'lY DIsPAR7.'MIsNT OF' 1I17AL'PI1 �
. PIiINCliTON,INDIANA
� TH1S IS TO CGIt7'L[�1', Cl�at om• records sliuw NICIIOLAS JOHN SCHAPliR __��(ci9
�i 5/2/78 nt 9:30AM Gib. Gen. Flosp. Princeton, Ind.
i month duy yenr hour ot dcaUi sLreet, hoapital, rural
I Age at llcuth 94 S�r Male _Colm• W�1��r`�4aritul Status Mar.ried
� years write whethcr murricd or einglc
Cerebrovascular accident
Pi•imaty cause of deaCh given was_---_
Signed by wm- E_4Y-�, �7D O,k �nd f'j�y inrl
phyaiciun or coroner nddresa
I.O.O.F. Francisco, Ind.
PI<<ce of burial ur removal
name n[ cemr,teiy addreas
5/5/78 Colvins Princeton, Ind.
DaCe oL buriul__
P4�neral Uirector ¢ddmas
S13At.
Recorded loc.�lly in boolc No. 9
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Signed
Gibson County FiculLh Commissioner
Oakland City, Ind. 1/2/85
addreas date
Pagc No. 63 Niled: 5/2/78
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