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Death Certificate - Wagner, George_6/20/1977.� �
RECORD OP DE,1TH ��
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GIBSOV COUNTY DEPARTIIENT OF HEALTH
. PRINCETON,INDIANd � �
THIS IS TO CERTIFY, that our i•ecords slio«� GEORGE CHRIS WAGNER
' --1.��24�75 . .. • died
at_12:30AM Gib. Gen.Hosp. Princeton, Ind.
month day pear hour of death � � � street, hospitai, rurnl
' Agu �i Death 7� Ses _ p�7. Wh. - -
Color �farital Status— Pfarried
years �vnte w�hether married or single
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� Pi•imary_ cabse of death given «•as Myocardial failnre • �
Signed by Wm. R 4Valls MD Princeton Ind.
- ph}-sician or wroner address
Place of burial or removal Prozir3an�A n,,..._ �______ , __ 1
name of cemeLe�ti� address v� y
Date of burial 10/26� Corn b7ortuary Oakland CIt , Ind !
Funeral Director address
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SF. AL Signe
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, G�bson County Health Comaussioner
(l�,klan__�7 _('i}�_� Tnd ���Q�77
_ address date
Recorded locally in l�ook No._ 9 Page No. 16 F;iA�;. �p �p_/?L
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GIBSON COUNTY ABSTRACT G TITLE COMPANY. PRINCETON, INDIANA
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