Death Certificate - Shanner, John M_9/16/1986RECORD OF DEATH
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GIBSON^COUN'I'Y DEPARTT4ENT= OF HEA•LTH
THIS IS TO CERTIFY, that our records
PRINCETON, INDIANA
JOHN M. SHANNER
Auqust 15, 1986at 5:45 P.M.' Holiday Manor Nursing Home Princeton,Zn.
manth day year honr of death etreet, hospital, rural
Age at Death 82 Ge�t Male Color�ite TZ�ta] Statu� Married
Y�� write whether married or �ngle
Prunary cause of death:given was Uremia Alzheimers Disease Benign h�ertroohv
of Prostate Arteriosclerot?c Vascular Disease.
Signed by Bruce C. Brink, Sr. . D.O. Princeton, .Zn.
physician or coroaer address
Place of burial or removai Mt. Moriah Ft. Branch, In.
name af cemetezy address •
Date of burial Auqust 18 , 1986 Colvin Princeton, In.
Fl�neml Director addmss
SEAL
Signer; ✓Y/ ���/ �°�.14ji
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Gibson Conaty Health ( mmissioaer
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Recorded locally in book No. 11 page No. 21 Ftiled: Auaust 26, 1986