Death Certificate - Teipe, Anna M_7/1/1980�
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GTBSON COUNTY DEFA1tTi�IENT OF HEALTH' ��
YHINCETO\, INDIAN.�. , - � -=-
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at�r;a r:�. T�.zPi.� �-;-�
THIS IS TO CERTIFY, that our records show �
F��3�g� flt_4AP'' Gib. Gen.i{osp.
month day year hour o[ death
Age at Death �g Se� ' e' Color '��h' Marital
years
Prir.ceton, Ind.
street, hospital, rursl
..:ilGiticG'
write a•hether murried or eingle
Atheroscler.otic heart �isease
Primary cu�se of death given wxs -
Sign�d by Ta�G� peck �' � Princeton Tnd•
physician oz coroner addmss
St. Joseph Princeton, Ind.
Place of Lurial or removal addrrss
name of cmnetery j Rd .
6/25/BO Colvin Princeton,
Date of
SEAL
Direetor
address
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Si8ne�1 �" ✓7`�/ �ZG.,_.d�� �=� 7
Gibson Cou�ty Health Commiay4ner
Oakland City, Ind. �0/30/�0
address da[e
I:ecorded locally in book No. 10 Page No � 5 �led: E�.�g� —
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