Death Certificate - Schafer, Edwin L_8/18/1987RE�ORD OF DEATH •
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G.SSON COliNTY DEP�R'I:�SE�'T OF HEAL,TH
PRI\CETO\. I�D[A\A
'I'I-IIS IS TO CERTIFY", that our records sho«• EDSJI�I L. SCHAEF�R died
P.uaust 5, 1987
day year
9:40 A.bi
hour of death
R.R.nl Box 316 Haubstadt, In.
street, hospitaL rural
Age at Deaih 79 Sec R�a 1 P Color�tL-,-;�1larital Stams `4arri ed
pears w-rice whe�her married or single
Primary cause of death given wa� Bladd�� Canc�r
Signedby Jamas ('_ Namhidae ri.r_ ��nn RP� lPm a. F.vanavi 11 7n.
ph: sE-_ian cr ccronee a�.�=s; -
Placeofbu:ialorremo��ai S+-= potPr ,.,r� p�Lyl uawt,ct�rlt, Tn_
name of cemeten� address
Dateofbur;al �'-lyust S, 1987 Sdade Funeral Home Haubstadt, In.
Fe:ner�l Direc[or address
SEAL
Sip�ecL °'N�j�'y�P�a4l'�6�/�1�
'-� Gibson County Heelth Co issioner
Oakland Citv, In. August 13, 1987
address date
Recorded tocally in book No. 1 1 Page \`o. d 3 Filed: Anm. s t 1 1, 1 9 R 7