Death Certificate - Tooley, Vaughn_8/12/2003PIKE COUNTY —
DEPARTMENT OF HEALTH
PETERSBURG, INDIANA
LOCAL CERTIFIED
RECORD OF DEATH
This is to Certify, that our records show '� C
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die : �R;- � � I a�_
.iom �ay� year
� �i�Age at Ueath�_ Sex , i�`-lii� Cobr
5
Primary cause o( death gi��en was �� �� �2��t� r:".\ n t� i 1
Siened bv _��
Place of burial or remov�
Uale of
Signed %!C • ,�/ •
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PETERSBU , INDNNA �r
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NOTE: Recorded locally in Book No. I/� ��� Page Na �1 � 9
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