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DEPARTMENT OF HEALTH
RECOBD OF DEATH
Sslem. Indiana
THIS IS TO CERTIFY, that our records sho~ ~Y'oy Felker died
May 25 1976 at (Residence) R.R. #2, Pekin, Indiana
Month Day Year Street, Hospital or Rural
Age of death ~x I"Iale _~~or _i~lh3te - Ma]~ried
Yean Write whether marrted or single ~
Primary cause of death was Cardiovascular accident _ _ ~
Signed by F• Dan Kelly Salem, Indiana
et - Address
Place of burial or remoral Croxn Hill Salem, Indiana
PTame of Cemetery Address
Date of burial .~T'~976 Daxalt Se~lem~ Indi8~le~
F1u~eral DirrcWr Addms
,
, . . ~ . . Signed f 1?~ ~
~ J 7~i.'i~- ~s ?%i~'1.lse~-,z~ Secy.
~ ~ . ,
- ' • _ . ~ Sale~, Tndiana May 27-1976
, ~ ~ ~ Address Date
Recorded tQcall~r ~t?i~'~ok No. ~5 ~Page No. 92
:
. - Leader Pubiist?ins Co., Salem, Ind.
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