Death Certificate - Walden, Essie E_7/14/1987RECORD OF DEATII . �
GIRSON COUNTY DI:PARTMI:N'I' 0� HEAI.:1'H
��awcH°roN. wuin�n
THIS IS TO CERTIFY, that our records show F4CTF F wAr nFN died
November 9,.198� 1:02 A.M. Gibson General Hospital Princeton, In.
month day year hour o( dea[h � street, hospital, rural
AgeatDeath �5 Sex Female Color B1ack�.laritalStatus riarried
y�e�s write whether mavied or sinele
Primarycauseo(deathgivenw•as Cardiac Arrest ( lYr.) Arteriosclerotic Heart
Disease, Cardiac Arrhythmia; Cong. Heart Failure, Type II Diabetes Mellitus.
Signedby K. t•iurtny M.D. Princecon, Zn.
physicien or coroner eddress
PlaceoCburinlorremovnl Sand Hill Princeton, In.
name of cemetery eddress
Dateofburial 11 /12/83 Kendall Princeton, In.
Funeral Director address
SEAS.
Signed_____!"'2!����'�9v"• "'����/
Gibson Counb� Health Co ssioner
Oakland Citv In. July 13, 1987
address dnte
Recorded locally in book \'o. 1 � Page No. 10 3 F��ed: 11 / 15 / 8 3
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