Death Certificate - Taylor, Temas_11/9/1977RECORD OF DEaTH
U'TBSON COUNTY DEPART�I�NT OF HEALTH '
� PRINCETON, INDIAN.1 .
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• THIS IS TO CERTIFY, that our records show TEMAS . TAYLOR died
��.,•,��''�19C�'(� at �y,�p�� 704 E.. Vine Ft: Branch Ind
'�.�month day year hour of death � street, hospital, rural - � .� .
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-� Age �at �Death 7'� Sex M- Color �•��iarita! Statu� .-, Marri d -
` � � � � Yeare ' � write whether m'srried o'r single � .
Primary cause of death given was Con�. heart fai 1 urP
Signed by R. G. GPirkr M•ll- �-� $���Fh, �nd
� � . , physician or coroner ' address � '
Place of burial�oi removal Maple Grove Boonville, Ind.
- , r.: �: of cer.:e::r� - . addrea� . ' - � . � ---'
Date of buri7�r�16%66 yaib --' , Ft. Branch, Ind. " �
� � . F�neral Dimctor address -- . � -
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SEAL . Signe ' �
�� Gibson County Heatth Commissioner �
- . .,:. -' � Oakland CitY� Ind, 11/9/77
aaare� aac�
Recorded 1ceally in book No. H-S� page No. $3 Filed: 2�14/66 ., �
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