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Death Certificate - Ward, Edward_8/9/1974� [� � _ ,. „_._ -_ _'. � '::� -;`� _ f f: �� � ,_ ..— . ' '� , �� . � ~�1 . 1�^.:t��i:. - RECORD OF DEATH. - - _ ` . = � ` •� _ ,j ; ,`. - _ �GIBSON COUI�TTY.DEPAR1il�IENT:��OF HE�LTH' ' xt' � . _ � t ,. .-�- . -'. _ : __ `PRINCETON;:INDIRNA�; .t a -�� ?S ' ��i� . it, _ "__ . . . L_ . _' _ - ' • i � . .. � . . i' °2x � i,. �_—_ � .� — i � ` _ � '_ i `�t . }� S t ;r _TiiI5 IS �TO CERTJFy, tha�our records show EDb*Ag17 �1, kr�lgIy : ^ : : . � � —. , � M.n2'.' 2 _ jg�li _ : = .:.; � _.... �. . '' d�ed { ::month , da ai- �, j � Spp! i GSb CrBPf. : _. �. t _� . -- -. .. Y - . Year . honr of death: 3 a .� � t HBSFi• �'12]CHtOII�- zDd �:';-i� ._ - . ._. .� - � street hosp�tal ruraj ---- . . �. �L. . ._ � .:t ' :�: � : �1. �°_'s� js.,..:_ ' .�F i � c 5.` i �ge at Death-!� a�e-= �Pfale =a� Co1or-` Wh1E� •i-= .:. #.� ,1� __:'� '>•t� ', �;- �.: .�—;f vears_. �r �.a z --�Mantal;St tus s_- -i'MypF1' _c: .,... _,,..:.�r_ �i-'- ,--i� ='.J:.--:�:—s; �, G�=t,._. .t_._I -- • f,�..... ; ; _.,_.. r;_. � : i P71II13T'y C3123B �--=�?-:='�• ;{�; , -_ . � ��: t=rr;.'f'la_t.�.. �:':'i:� ,.r f, Signed by= � � ='; ( r �' v .tf � � -.�.; t��� tPlare.�f h,,.:�i� � t ;.�� .r, �:�a �. -_,_ i s � 'Date of buriaL .:.e ��-- : - � } ii �.i ' ' .s C\1'\�~!, ' ;� �. ,_;�iSEAL,';`; � � . '� i. . 1� . �t�), _-t: Recorde� loc�.l�y t ,t^� = ; - _ :: .- _...._._. --_;"_ �� ` _ +`.. t i.'..,_, � _ �• ;i :i ��, t ;i."_..�;��i" =:write: •t��a� �.=f`=°;;� ji�._;i:� _..�_ .ss-n�tt�Onl�: � :` ° °?_-.' Ei-'.�i{ ��1���� .j.� 1 f� .7����' S�'� `i 1. js ti..` �i�: �f =t�. -t � I ^'t: #.i:d � }�---r� ����. nOi =�..-I/ . i .i.. i '. ..�."'� ' -- ' : t i-"`?�-- t �—�'3: �----_-_�f.1-�GSIw.S A:'' , '.9 r ._t �' `� f� ii< i � rt b� ;S °� ,..: i� i. ��.,, ��; �_.'_ » , 2daT253 s'°a--, _ _ , .i--' � 3 i;: .._. t �Hialllanfl�f�iersor5:s1 '== ` •,.,�"-, , .._._, j`}� � ,: oL'cescetci'S., - �� r e_ ..•. PI$ c'='Creris�l:-- yY r e i "� ' ''•;addresa:: f---- ;7' . _ 1.�."'.3' �t '�e�,�.-'�i:^''._., -:' r t - -.: r�_.� +.t�s i..�, j . -p . , _ .. ---�.. 1_ DixezCor . . �. „�'t�qE . . r I�..:'°,i �z._-"'- ��� __ :-�-.ad—_dress- PS`f.Y1$��-0�'i,r 1T.2}d.-. `- ';' � e�'_" ' _ �. �1 il )i �J ^ ! 2 � . 1 . � j I. . -.. � , .. e , � . , , ._._ _,__ .. . r -�. �F 3 . � � � � w' 3 .i s. � . � 3 � '%� � � ` : ' - �_ 3t �- � � /`J � :_. � s.. � > '. � i. _ t � - �,� • i ?�/�,�';,, - � ir , �.^'�.Sign. - - �k��G�Z/',1�:_._. - .�. „ ' .}i _..... .. . ._. �.•:� .--;:.... :� �� •.:-- :. - ' Gibson _Cotmt9�Hea1 .-"—""-"'=' _;1 ' -- k -'t.. th�. Commissio��er _ ::�� r� �-._:: i " " , _ � ' ' ., �1-'- ��i;�-�5.�$19�i!+ _ - ' � �• .--.r ` � . .addre.s � �� ��� � � .. �,... .- .i . �a, _ - :i ' ` . � ',- ., __; . �' 3 datc ;ti �—�--�PSgf? '�TO�__�i7r'--�+'1� C(1 'Q ,rJL t . ; . ! . -r s � .'- �°7..%r'_"-- --'--���e_� - , 1_ 3� t ''-�f tl �' �:. f'i. s ���'i n._,�::,`:: � --. � ,Y � .. .; �i ,, _ _ _, . � ; ��.F,__,: ,--�� �3 �� '_�. ,•� +� - � , � • ' , � t tf � . -_�� r �.� �:� 77,�,� i+ , t �. ' } ,.i , _.._ t I - _7:-`., - -. -.-tt---.ei i._`---1�i t ;?:1