Death Certificate - Seay, Fairy Grace_5/9/1996RECORD OF DEATH • • G)1�—a b5 �
GIBSON COli\TY DEPAR'I'�IENT OF HEALTH
PRI�CETO\, I\DIA\A
THIS IS TO CERTIFY, that our records shoµ� EAIRY GRACE SEAY died
Dec. 21, 1987 a� 6:55 P.M. Gibson General Hosoital Princeton, In.
month daY year hour of death street, hospital, rural
Age at Deach �� Sex Female Color ��hite `qarical Siatus Married
yeers � write whether married or single
Primary cause of deach given was Cardiogenic Shock, Ischemic Cardiomyopathy.
Signedby, Arun C. Kumar, M.D. Princeton, In.
physician or coroner address
Placeofburialorremoval T':dlnut Hill Ft, Branch, In.
name o( cemecery eddress
Dateofburial December 2d, 19R7 Alvin Finaral HomP, Tnc^_ PrinnPtnn, Tn.
.,���� Funerel D'vector eddress
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tj=i�ri . �:L.¢.�.�.�A.D. t9 � Gibson County Health Com sioner
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�,si�-� AT � O� O ►R. A. N.
,.�.:'� ��p�p� ,o� Oakland city, In. Jan. 4, 1988
�C�:..::�i:.z�> �'Y'�� -x�.�r,.f._._ address
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Recorded locally in book No. 11 Page No 5z Filed: Januarv 4, 1988
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