Death Certificate - Tooley, Andrew_2/5/19820
RECORD OF DEATH �
�
GIESON COUNTY DEPARTIIENT OF HEALTH
' PRIVCETON,INDIANA
THIS IS TO CERTIF'Y, that our records show A���� M. TOOLEY ��
12�26�81 at i1:55PM Gib. Gen.Hosp. Princeton, Ind.
month day year hour of death strnet, hospitd, rural
Age at Death 79 Sex �' Color '�h' Marital Status M•
Years �crite «•hether married or =_ingle
Cerebral anoxia secondary to cardio respiratory -
Primary cause of death given was
Si¢nedby Bruce C. Bz�ink. Sr. 1�0 ' prinrotpn_ TnA"
physician or coroner address
Place of burial or removal I.0.0.� _�'ranri crn �Tnri .
name of cemetery• address
Date of buriaii2�29/$1 Colvin Pri�ton� Tnd.
F�neral Director „---.�; address
s�. :�
�'x,"r� / , j �, ^,��M� � � �+.�J
' (itJ "�' �i � --
SEAL Si¢ned � � -
'� ^;`j Gibson
f. -
Dakland C
i� � address
V�
ity Health
_�,
�;�rnd.
Recorded locallp in book No.-- ��---Page \o._ 56 Filed: t��*�52
2
��