Death Certificate - Stewart, Forrest_12/4/1985�
f�ECORD OF DEAT[i �
� ��
GIBSON COUNTY DEPARTbIPNT OF HEALTH
PP.INCETON, INDIANA
THIS 1S TO CERTIFY, that our records show FORREST STENIART
6�12�81 ,�t_2:45PM Gib. Gen.Hosp. Princeton, Ind.
month dey year hour ot 1c1tL street, hospital, rural
Age at Death 64 Sex M. Color Wh. IYIarital
yeara
Primary cause of death given
f testicle
write whether married or =_ingle
Signed by James F. Peck, M.D. Princetori, Ind.
physician or coroner address
Place of burial or removal Mt. Olive Mt. Olympus,Ind.
name of cemetery address
Date of buriai 6�1�/81 Colvin Princeton, Ind.
F�neral Director address
. ' �
. SEAL - ' Signe �Z � ' r`'�'�
-. � � Gibson Coun y Health Commis er '
Oakland City, Ind. 6/22/81
- � address � date
Recorded locally in book No. 10 page No. �Z Filed:�18�81