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Death Certificate - Williams, Jesse_4/15/1976�� -.i . . ... . .. ... .. . -,. . . . ,<z.., - " �. �� . - �. !''� ��t ,� . �.i .�<=., .si; 's'. .' f;''''t tl �,' t .. . . •' . i t� 1 i t ft �i. l� . }� RECORD. ' .� � . ..' . � s < 2j ` ` �s. ��a�F �it,�t�..+ � a �? OF'DEATH .: : • , '•.!'' . . , L ' s;�, > �sr� r�,� �3��'.. pt°.�.� ;. GIBSOA� COUNTY DEPART\1EATT OF HEALTH `- '��;' t '_ '" `' )� � . . , � z: �� 't{� �� ' � � . . . �. PRINCETON, IhDIAN� � . . c�� ";�. �+�t:` �� .• . . "a'r . . _ ' � .. .. ... 7 : •. .� : .. ..�'•F� � e ��.. ; � � . � - - • • 'JEBSE HERMAN WILLIAM9.' ,`< < . .` . THIS IS TO CF.RTIF'Y, thaE our records show `' died � ;� Sept. �6, 1g�4 at4t00 AM Gibaon Gen. Hosp., Prinoeton; Indlana,� �•'ur.,w..� ' �' ��F� •�r< �'��• 's`-,=' . moriN ' �day. ��year ,` hour of desth - . ... . street, hospital,;rural � 'i� '' �� +z�.t ,,,,, „ .;--• -�'1.:• •:'•.: .t;,. . � - • .- � , ...��<!.c„t�rZr __ 3y.� h 72 Msle White ,� � I�arrleQ � - Age at Death Cex Color DIarital Status � ' _ years ' write whether married or single Cerebral Hemmorrhage ' •;��: �� . Primary cause of death given was ' . ' ; ;;, � � �.': � _ ` " _ . . Arterioscleroeis Generalized ' �� ; �=: �: • ,�,; James F. Peck I+m - • Princeton, Indiana ' . Signed by :`�� . . . _�" � - pn}-sician or cotoner- �-� � _ -- -- ' � � --- -- �address � Place of burial or removal I' O.O. F. FTinCeton, Indiana' ••' ''• . � ' . name of cemetery . address 5: �: ; �_ � , :� 9/S/1974 Colvin & Son Mortuary Princeton,, Indiana.. •�";;�:� ""� ".� .': �� Date of burial ,- „ � � � F�neral D�reclor address � -- - . .' � ... � ' - � � /� /� ' ' "^ '+`;.{: . . . " . � ' . � . ' ^'a! HYA/ Y - • <. � ... :i ' . _ --'. - w � � /J�t� ' ` , SEAL ' . . f - .- . ��ed ' '' � � . �. " � � � Gibson County Health Commissioner ' ` ; � . . . ' ` . • princeton, Indiana , •,9i9/1974'::�';: _ i� -" • - • �>. • . ' .. ' � � , . � - address . : . date - .. .. . , Recorded locally in book No. 8 Page IvTO. 102 Filed: 9/9/19�4 '.. ..'.a•`- ;�::'• s.;, . -' ; _ _ ; . • , � �� • --- ------- . -, I --:—__;-..,_ . . .. --..�- ---•--- ------ �- —=-----= •--'- ---� .