Death Certificate - Tucker, Levi_3/10/1976.; -
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RECORD OF DEATH •
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GIBSOAT COUNTY DEPART�IENT OF HEALTH
PRINCETON, INDIANA
THIS IS TO CERTIFY, that our recbrds
LEVI TUCY,ER
montb.''- day yeaz hour of death street, hospital, rural
Age at Deatli �3 Sex Male. Colorl�it_�Dlarital Statuc MarriAA
years �srite whether married or aingle
Primary cause of death given was Pulmonarv edema
Signed by B. C. Brink, D.O.' princetnn, Ind
nhccici2n nr rornn?r grj�lro�c
Place of burial or removal Owensville �Owensville. Ind.
name of cemetery . - address
Date of buria�4/F/�K xolder Funeral fiome Owensville, Ind.
`� � � F�neral DirecWr address
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'.SEAL ' ' Signed
'� ,, Gibson County Health Commiasioner
`:•i Oaklsnd Cltv Ind ;�/in/��
, aadress ��¢
Recorded locally in book ATo. 9 Page I��o.—�iled: �/?1�/�.,r
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