Death Certificate - Waller, Bryce A_7/8/1981RECORD OF DEATH •
�
GIBSON COUNTY DEPARTnIENT OF HEALTH
� :� ' PRINCF.TON,INDIANA .
THIS IS TO CERTIFY, that our. records shoa� BRYGE ALTOIV tvALLER died
6 26 1961 at S:OOAm ' S07 I�T. BYain, Ft. Branch, Ind.
month day year�� hour of death stmet, hospifal, rural
Age at Death �6 ge� Male Color White Marital Status Married
years ' � write �chether married or single
Prima�y cause of death given was n^yocardial Infarction
Signed by Wm. E. Dye, M.D.
physician or coroner
Oaklar.d City, Ind.
address
Place of Uurial or removal Holy Cross Ft. Branch, Ind.
name of cemetery uddress
Date of burial �/29/�l Stodghill Funeral Home Ft. Brarch, Ind.
F�neml Director addrnss
SEAL
� r.
'� , � �
Signe �. .
Gibson County Health Commi oner
Oakland City, Ind. 6/�0/81
address date
Recorded locally in book No. l� Page No�3 Ftiled:�29 81