Death Certificate - Wagner, J William_8/4/1986� F�
RECORD OP DEATfI
GIBSON GOUNTY" D�P�IRT�IENT OF HEALTH
PRINCETON, INDIANA
THIS IS TO CERTIFY, that our recurds show
LLItlI�f WAGNER
3/15/85 at 5:45PM Gib. Gen. Hoso. Princeton, Ind.
month day Seaz hour of death street, hospital, rural
Age at Death 78 Se� hiale �o�or White�Iarital
years
Primary• cause of death given was
Cardiac arrest
blarried
write whether married or eingle
Signed by u rn r��v ;.u� PrinrF''nn Tnd. --
physician or coroner addre=.s
P!ace of burial or remo��nl St. Joseoh Princeton, Ind.
name of cemeterp address
Date of buria
3/18/85 Kendall Princeton, Ind.
F�neral Director address
SEAI.
�
Gri ��✓.�, �° ,�'� ��..v
42 �
Gibson County Health Commissioner
Oakland City, Ind. 3/18/85
address date
r 10 pa 141 Filed: 3/18/85
Recorded locally ir book ho. ge No.