Death Certificate - Wagner, Arthur_4/14/1977. � . . .
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RECORD OR DE:CTH
� •
GIBSO\ COUNTY DEPAET\[I:\'T OF iIE:1LTH
PRI\�CGTO\, I\DT:\\:\
THIS IS TO CERTIFI, that'our records sho«•_ ARTHUR W. WAGNER died
� AuR. 4,_�Q74 at_bAM Qvrens�zil-le—Conval-eacent—Cente�—Oovenavi�}�,—Inc},
'j=.` . month da}� year hour ot death street, Lospital, rura
� ,Age at Death 67 ' Sex A'Igl� Color_ Whlte \Iarital Status ��� �TT1Bd
� }•ears ' � �crite u�hether married or single
Primar5• cause of death given was Aeute_Iny_p.CardlaLlnfaTat
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S;gned by TerrgA.-S�h,—T4TD..—=—�asey_v1�11e,�ncL. _ _.
-..-.-..--'-'- '-- physic�an or curoner � � address . .
_�._. �larn �g i,,,,_•���_..r re*nc�•al " St. JnePnh- - - - F4A!1ee12i��_=1i1u. '
� � name of cemetery address �
Date of burial_8f_'Z/74 Eauatain_Tet���Ea�t.._F2a�SV-ille. Ind.
-� Funeral Director address
SE9L
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Gibson County Health Commissioner
Princeton, Ind. 8/6/�4
address ' date
Recordecl locally in'book ATO. R_�yl—Page No.�l�Fited:�6/74 �
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