Death Certificate - White, A. M Delbert_1/31/1974RECORD OF DE�1TH , •
- GIBSON COUNTT DEPARTDSENT OF HE9LTH
. - . _ � . PRI\CETON, INDIANa � � --
THIS IS TO CERTIFY, that our records show � A. M. D�,r,RHRT tdRTmF ' died
Jan. 22� 1<J']4 at .11r15AM G1b. Gen. '$oso. Prinr.etnn. TnA_
month- day ' year
-� hour�of_death
rural ._
Age at Death 72 Sex Mal P Color idh��e Marital Status_ Marri ed
. - _ _ . years � .. � � � _ � � � . . - � � . - . �vrite whether married or single
Primary cause of death given was TntPrtrnr.hantPric fracture Teft hiA
Signedby . William R. taPlls, L�•n- Pr+nc�ten, I�-. .
- — -physician or coroner � � "' ., � ""-'"-"r � ' address- ��"— . ' � ' ' �
Place of'bui•ial'or removal ' -" j`�hlte Church� Frinceton 'Ind.
� - ' - . � . � ' name' of- cemetery . ' . . address . . . . -
Date of bu11a1" 1�2�F�%!Y Cnlvin- Rr S�n � � PrinrPtnn In�i. .
� � � � - - Funeral Director � � address - - � �
\ �'' �" '
= SEAL
. . . ` �`���:«�'" ' �%� � � .
Signed
� � �Gibson County Health Commissioner
' Prinoeton; Ind. 1/28/7�
.. . . � - address . • . - .-. . . date
� ..
, �
Recorded locally; in book ATO. R page No.—_�-0—Filed:-