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Death Certificate - West, Butler J_5/6/1974! � � � �2 i"�i�i� ��r��.ir � �! �' .. `.'. +t �{ , i, a ti (t� (� . �� t _ � �a '� } � 2 ' � �z �.� �1 t � 1 1CORD OF �DEATH _ � � ... . . . ;:' . � �' � +; �. ! ' ` � GIBSON COUNTY DEPARTDIEI`TT OF HEALTH �,_,,, ,,,g� � � PRINCETON,INDIANA � f" � .;,[ � '.� � 5. . . �' . ' ' • � � ,' 1i it::Tty».)'�!� �. .. \ ' __ . ' ' ` . " � - . �. Y - 1 `. IS,IS TO CI`s�RTIFY,` that our'records�show BUTLER J. WFST _ � �.. eb ` 16 � '`iQ74: �•:at i'OPM �� 209 West Street � ' Patoka, `: Ind �} month ' .day, tyear -. � hour of death •� . ._- - �- • streetJhospital, rural r , : • •:..: . r }J; ..��-e rl1 f f� Y..� i.� - - � �..� . 1�.. . . ,t'?.�.� � �• �� •:1 Y1.�} � . e at,Death' �� •'" 3Sex_L�lxle` Color tdh�te• �Manta1 Status -- •� •f�� . � years.:.. � ' . � . . .r. wtite�whether r . ' : f. .', xj . .. . . y . ; j � _ . . p . . . .. . . . . . mary esuse;of deatti;.giyeri waa '� Coronary t.hTOmhnst c, '` �`�:: � +. ' ' 17 { � - � .. . ° i _ � �„'- ' •;�•1'' �f "_. - � # �' . i�- r xi -_ . - . �� t �� i� �r � � b e : �'� i ' '. _ � .' � .:`• f.�Sigfied by� �EAobert D.- Kendall �-�Cnrnnpr� �.PrinrPt Eri;� Iri�� - � '� � : ��physician or coronex' . � � • address � � � ^'" ' ' i e � . �� .:'� - . � � :. +;tPlace of buna]'or removai �`� '� IPO�'MPmnT�al ta�r;r�wx,�� Vir�lnia � "" � �;�� 'r _ �..name of cemetery ' ' � address 3' r „i� . }� :. ,, : , •. , .j . ..t.... ;; !,Dafe oY bunat2/21/7�+ '' Provt nce • in �ral� HnmP " Penninaton''Gap V -� -�' '+ ,�.�,... F4meral Director . address. >�S ��z� - -1 _'. � e "�tq' . . '_ ;�r . .' }. M R ) f�� i Tl� ,�hSM1I, ; .../ t . ,. , e t ��• i.. �! .� ; r' . • -i'. i � f �, . = t i,, � `l ' . _ - . .., ( , r � SEAL " s � . ' . Signed ''. • .. . _ �� , i�L +�� : , r.- .. , 3 � ' � . � , - � � - . , : - . Gibson County Health CommLSS�on � � � � . �, 7 J.W 4� . y � . - : ' . . . . . _ . ' -. e i W�� ,.-� �, �_ `..� . _ �.Princeton,- Ind. � "576/� , . _ f . ;. ( �� .j�' .. 7 � � � �. f . ` '' � '. SdaI'055 . t 14�� '- 1 J��1 �� 1��,` � ' ! �:�� ',"�, ' ".'` � •' � '�� '�� ' , ;£Recorded locally in 6dok No A_<1,�� ; page No.�� .Filed: 2/27�71G ` � � � i, t � _ r+ . � < _ . • . . ,- � ,t � ,; � {f'� �� ," ° � , ' ' .. * . ', i ^r�+ . �q-. ..E� € S � -� ..'W,� . ' - ' ' ;' :' _ i. `.rS, :�t. �t .�z t..�.:�:. = � . ,� ,. _ . � . ... � 'iS �� . — ... �. ,.. ..:�.. _...�� ,... . '� ... . . .. .. . . .. . ... . , . . .... . .. .� . . _.. i� . _. ..il o, i� _°, , � s . ;s , i! , > '. ,'t . �4 � - . ,i . �� '.'j��. F t . `` died '� ' � �� l � i i�....-_ ' � :.: . ::.�� c t... . ' . 1-.. - e � , =?f:".:r,�.•;� . i,, '_ � ,i�. . � '` i�. .. , . �:: � ,�' � � e�- t, s , ;,..- . 1 _ .�;5 �.:i a �--t SI. y ^t _ //('✓ ` .,: Ra � _,5:.. er'' , �� 7 �. -i�.t�_St' l�.� �� daTe�. . � � �� ie ` , ; ` ;,� x� , , , , . ; � r i ti :i ,..t . _, .