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Death Certificate - Wilson, Elmer E_8/5/1974i.. .� � . • � ,.' �. . _ ' . ` � • . F-� � Y .ti � 1� ` .) �� - . .. . � ' .. Y � t -. ; . ' RECORD! OF DEATH , .. O � . ' • -.� � v � 4 � �? + '•` � GIBSON COUNTI DEPART�'IENT OF HEALTH ''t *',i } •' . t �t; : , . f < ._� �; t � ..ti 'i r . j, �'.. ' . PRINCETO\, I\DIANA . . .. '' s s�� ` i�; tr ,. : f� ` . .'- � � ' -. - . ' � 3 ,.:� . '.:;:' THIS IS TO,.CERTIFY that our records show - ELMER � E: ,WILSONy ., • �e.`c i�•• �ied; ;,i��May,14; '196� r' :l�M ;; 401 W: Montaomery ` 4 Owenavi �P;� Tnd at i month ,,..�day � year , � . hour of �death � � p�- street ho�p3tal rural �j � -' � � S ., � _s - ♦ t� � � �1 � �.. _ �. [ 1 - f : . r ' . ��{ir'Y5i ^�£i � 1� . . : �t. �,� i�- . . ( � . .: _ ,_, �t �t. ... _ � . �-�„ ,,,.y3�' R,�..�'r� �( .. -,}: �'»,8 t.._�- � .. � { .,�,-,Age'at'Death rii ° Cex ''-` Ma ' " Coloi•" Whlte " nqarital Status �" � �_TI'!ed " '�'� • . .... le , ... r � .(..•' - ` years -' _ , . .. ^ . . . - ;g�write�whether mamed.orsingle� . s r°� � -. -�. # i � �..." . j � .. ��.. .: � . =. .> i'°, ...'� y� ` � ...i i:. ' Pnmary�cause of death given was `13YoCardlal Infaretlon,�inritan.� S� _f ;` "` !'�,; ,- �r � . . • . fi Y Y• I!{ �. � 3 .)a ♦ . � �1 � i• 1t,1 f. i i . t e � n. -�. � .. • . . � S�'��y ��si t �t� � , _ � i[. � �j ��.. – ' Signed by. y � `� , .. ' . : .. . , `: } ^ ` � � ��'� .��t �' nh�sician or wroner ` . a � s� i " - � . . �. .._ , .., . - '� . ; � � , ;� _ .' e tlf. - ' i . � r . � .. '• _ . . .. �}.; a�i �jiv - • � `Plaee of 6uria1 or iemovai ' ` 'Liberty - .+ Cjmthlana; , Ind. �r � � �; � 2+. ' name of cemetery , _ address -- �_ - � __ �,; . r :. . ' ,,: .. , . c ` ' it 3x , . . .� � �""Date of bunal K�3(�60" � � Dau� R �e��er " n0' TQ°ille� ;Ittd ` ' " , :,I •' ' ; . .. . e , Funeral Director- address � ��-� ` I v�. „'� �.i . . . J � ry }y-,i.�� - r. a� - `�`� � ' � 1 � ' _ q , . . �" . � q � j 'S e �J� t C � 7 . •. � � i . � _ '_ _ ' y ! . f'f t . s p i +� � . . .. f . - t/_ . . . 'l . ..1� .f _ � r� i✓. 1 ' `t ) " r SEAL s. . , ; Signed ' ' _ ��. .> , � .{=r ` r - �,,.�, -c�;'�„_ '�•r �� - " � - Gibson-0ourity. Health� Commissioneii„� C' � . �'. 5"F t. •. . .• . : .� - t ' x �- ��a _ t: . � �' � t 1: � . ��. - .tPr1n'r."p*p�• '�3it� ' ` 8/-5/74 :� r . .. �- . � � � . . address . s t -- �� .! •._ . 7: .4 . .. ` �i., f � ... 3 �� y �. �..f', - : �. � ' . .r 4R , y . ,. ' ,Recorded�l�ocally �n tiook No � H�LS�_—page. No—_l�.3__Filed: r,�/��q; =e � '� �� ~ ' �Y SI 1. ! t � .. � !1. �S. p.• � Ji. 1� :- � , � ;'J � , z _ � . - . . .. e - i ; � � . `` �. .' r � ' � �.k . . _ t is �:i.; � 45 :�} ��} . � ��+ .f �� ' .. ., ' i i [tr � -.i � � �- � � t i . 1 � _ ', ,�.._ . ., t . ..�� . ...�.. .. _.. _.. .—� ... ._ . .. .....�... , ...�} _ ..._I �t� .` ",L /C'� :.4–. ?e _ r'