Death Certificate - Wirtz, Lawrence_10/12/1978r ' - _—�
RECORD OF DEATH � �
� GIBSON COUNTY DEPARTI�iENT OF HEALTH
; � � - PRINCETON, INDIANA
THIS IS TO CERTIFY, that our *ecords show T AI�IAF'Nl�F T y�7RT7 d��
12/5/74 At 6�3oPM Gib. Gen.Hosp. Princeton� Ind.
ri�onth day year hour of death atreet, hospital, rural
Age at Death 6o Sex M� Color �� Marital Status Married
yeare write whether married or eingle
Primary cause of death given wae CanCer of lung
Signed by James F. Peck� M.D. Prmnceton, Ind.
physlcfan or coroner nddreea
Plnce af burial or rnmoval St. Joseph Princeton, Ind.
name of cemetery addmss
Date of burial 12/9/74 Colvin & Son Princeton Ind
� FY�neml Director nJdmas
SEAL
•
s�� � �� � � < �,b
Cibaon County Health Co asiuner
Oakland City, Ind. 10/12/78
eddreas a„�.
Recorded locally in book No- 8 page No- 108 F;��; . 12�12/74
. _ . � . , . ' . . �-r��_.. i . .
. . " � .. . � . . � , .i