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Death Certificate - White, Ray_4/10/1967RECORD OF•DEATH• � • • '� ' . � ' � •- _ " • ' - GILSON COU\Tl DEPARTDIENT �OF HEALTH � . .. ' . . . . ' .PRI\CETON, I\DIA\d . � . . � �� • � _ � ' , � . . � - . ' . �. �' � . � . 1. THIS IS TO CERTIFl; tliat oui-recoi•ds sho�d MAAY, I• WKTmF . . . ,__, , ". ADril � '-5 1967 . '�at8:'30-AM-Gibson Ger Hosp-Princeton,Ind., . - month � � d'ay . � � 5-ear- � - _ " hou� of. death �� - �tree[, hospi[al, rural � 63 remale, � � White Married ' `-. Age at Death Se.� ' Color ' - • � years � � � ' � -_ - _ � . ' . . �crite. �chether married �or ;ingle - " • � � Primary canse of death gi��en was Adeno-carcinoma-�of 1eft; lung.with abdomina3 : �- a�d cerebral metastasis �� - �, Signedb�= Ii. S =.McElroy-,.:M,ti:. _ .--- • - Princeton,•�Indiana- _ . . _ . .. . phy�sician or.coronec ' �". , - , address : ' - Place of burial or removal Maple: ?�11 Cemetery Princeton, Inciiana -.' . , � � � � �..name of cemeter�'� � _ . - '_. .� address � � � � � - . - •�" ' . . . . . . . .. . - . _ "' _ - . Date of buria�-7�-67: Colvin & Son � Princeton, , Indiana �- .. � . . �'.`.,= - �' . -Fune�al Director . - .. '. .- - . a dmss l . :` ' - ;F�_ . r '� �/�� z�CCGV ./ .�: . SEAL �,�. � Signed, /l.�Y. � •�� /�. � , " � � - ' .. � �i,. � � ' ' ' �Gibson Count>- Health: Commin ioner � � _ _ . .� . . :t. � _ Fri_nceton, Indiana . 2-10-67 ' � � .- ' � .-�'. - � .address . ' - . . - . date . � . . ^' - - . . �.� . � � . . . . � . . . � . _Recoi•ded,locallv in book.lTO. 7' Page No. 17� - . . . • . Filed 4-SO-67. . .: ' •