Death Certificate - Wagner, George_4/28/1976;� _ .
�
- ~ ~RECORD OF DEATH �`' � . �
� GIBSON COUNTY DEPAR.TIIENT OF HEALT`H
,�. _
- PRINCETON; INDIANA _''
THIS IS TO CERTIFY that our records ��^�_� GEORGE CIiRIS IJpGNER
io/24/75 at `�ra,�3onr1
month day year hour of death
Age at Death ��' Sex Male
years
Primary cause of death given
M,yocardisl failure
rural
,� �
�I
Married
a-rite whether married or aingle
Signed by� l�mr_.R. LJells, MD' Princeton, Ind. . �.
••?:•.-:^i^r or co.-one: � add-te�s
- - r ,.,..... . _. _._
Place �of burial or removal PTOaidence � SnmAiville,. I�d .
� . name of cemetery address
Date of burial �klsnd CIt Ind —
neral Director � � � address
,
+ SEAL
i'
��G-��� �
�z�. ������ -
Signed �`
Gibson County ilealth Commieeioner
Oakland City,.ind, 4�2g��h '�
aadress �t¢
Recorded lceally in book No. 9 page No. 1� Filed: 10/30/75 �
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