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Death Certificate - Wagner, Ezra George_7/17/1974:, .. --� - �w . - _.- ,_ .. -- -- - � ._ 'RECORD OF DEATH _ . � GIBSOi1T COUNTY DEPART\IENT OF HEALTH -- - - - - - - - - - ' . -r:� • ... � ' �. � - � �- �PRI\CETO\T, �I\DI:11?� , ' , ,. . E7.RA GEORGE WAGNER - . THIS IS TO CERTIFY, thaE our records sho�e - .! died : Feb. ,15 1967 at 9�20pm Gib. Gen. Hosp.;� �(enroute)__ '- -_. � .+ -. . - -- � - month �� day year hour of death streei, hospital, rural �•. � ' �. � ' 62 Male. White � � 'Married`'. �=� Age at �Death Sex Color \farital Status . � years ' i n�rife whether married or single Myocardial Infarction i hr. . Primary cause of death given was � � � ,. .._ . � ' ,; :;., • .. ... ._ .. '' ,,. -, , :t:� ,: . ..Jamea F.. Peck.NID`.'''.". ceton d a-._..__ _---- Sigiied by• _ Prin ; -Zn ian. � �,-. �-:.s�a.: . _ _ — _ _-- ;phpsician'ur'coioner '' . . ... ---. add*aes . '-- Province-Cementry - -- Francisco; Indiana Place�of burial or. removal ' . - -' .. . name of-cemeten� . . _ _ . . . address - - -. _ .. . _ . - -' � '- � Date of burial 2�18/196� CoTn MortuaTy Oakland City, Indiana � " _ _ ,_ . . E}inerat Director - �"' � address -.:." . . : . . . • . • . .. � -.. _ .. . �� i . . .. . .� _ • � �� .' .. .. . - . . "� � /�.',o ''R� ' • ` - :SEAL - _. .. . Signe . . ��%�tC��^""�G — . ' . � ' ' , , � . ' :,. Gibson� County Health Commissioner � r.�. _ .. � � .. � _. . - � , _ Princeton, Indiana �/i�/1974--•.�,� - . . ,, _ . . - .� - --. , _ . ' " address= - ... .. ` .. date -::�' g_Sp , .93: � 2/20/106� _ Recorded locally in book No. page�No: "'Filed: ' �. -.�, - :i,. + ;. + . - .- c ; : . . � . . � ---' --- — ---...__.. -- � -- - - --- - -- -- --- -- .. . . . . ,.. ' � .. .. . ' � ., � ' � � � . ., . . . ._.____ _ . _._..... ,- .,...a .�'-..:.