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HomeMy WebLinkAbout1378 j t i 1 ' HENRY COUNTY BOARD O~ HEALTH NEW CASTIE. INDIANA , ' ~ CERTIFICATE OF DEATN . . . V~ ~ t~ r~ t~~ p~~ that according to the records of the Henry Couniy Health Department Name of deceased Otw111e V~, Mel rne Dote of death JLL~.~I 22..~ .I.~SL at 121 S. Mlef_UZ~um St_ _ Kniehtete~a~_ indiall~ . (Ma~th) (Dap) (Ywr) (SfnN, Hospitd or Ru~ SEX COLOR OR RACE NEyER MARRIEp AGE If UndK 1 Y~ar If Und~r 24 Floun Y~+~ MOtiTNS DAYS HRS. MIN. WIDOWED DIVOfKED (Sp~dfr) Male White 61 Primary cause of death given was _ Carcin~T-Livsr Motait~c ; Certified by r 1 t~l_D_ ' Nw CaSt~E, IqdldOa ~ ~ ~ ~ ' ~ ~ r .~l~ or coroM.) (Addrw P~a~e of.:~aT.=or~c~m6Y4~ellats C~n. Carlisl~~I~i~ -i _ ~i~ c~~ ~ Indiana Date:of~bi~iidJ,'~ p~ f~neral director 611t~11@!" FIJflEI"dl Ii0111Q KI119htStOM11. ~ ;s ~ ~a ~ ~ Ls ; : (Addr~ss) Retord~~:~je~:~ _ F$- - " ~ III , 48 ' _ ; f' ~ ~ ! ~}t~~•:•4 ~ , ~ ~ ~ ~j~`!i~ "y~ ~ . '~i.• le ~ { ! `~~~~~!0~~,~' ' H~ahh Off'wer i - ~ ~ Issued on ~ N1a~"ch 3_ 1975 , 19- G 4 i ~4 3 ~ 8 ~ u $ ~ ~ - ~ ~ ~ ~ ~ a ~ ~ '~3 ~~~~~,~titi_ E~~~~~r F~~1: e~ . ~U. ~~1 ~t, ~ e~_Er~~ ~~~at ` ~ P'r.Gf'~I.'.'r=1~;f~ e~ ~ - A~R 1 55 PM'1~ ~ „3 ~ 3t~~~9 ~ ~ i ~ ~ - ~K238 P~cE1377 ` ~ vJ ~ ~ ~ . ' ~ ~~X~~~,{,u ~,5~ § ~~-~ar _ ~~..,_s' t ~ ~ . ~`~a . _ `~'E 'y' . -