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Death Certificate - Bolin, Frank S_9/28/1970:' ` , � t r• , _ . � ' � � ; �; � � _� ' � i ,` � -- _ --- � . ,' RECORD OF�DEa7H ��. .:� ...�. �.� � '._�"�' ;•- :•�c.�'_ ' �� .'' ;l ', ;�� - _ _ _ ' -1 ' ;��: GIBSON COL\TI�DEP�1RTJiENT,OF HEALTH+� '� _ . �. , . i � .�: �-. ,t - , r ' _'1 .:.., i� � _ , „ I- � � _PR[\CETO\� I\DIA\a • - �• � "'�'' �.- - - .- .�. _�i f ' �i� — - - " � `.� 1'.� � : . . ��. � � 'i :.. �� .. '_.' i . ' _i . '_ TIIIS IS TO CERTIFY � that our,recoi ds sho« �'- � FAANK S: BOLIN � '� - - d�ed'.._; , � . ..� .,. .,. �. ., �,. i .� - '.- ,� i.� ;� ,:�:�,�_— : ' _ :_ :� : �, : '� _� i : .: • _ _ Sent: �_ _ 24- -- -� 1970 �!-_at l0Ai+1 ^ ;Gib. -Gem.r' Hos� -Prinoeton, I:'d. • �" - montk �' � � � •' �dav' i � � � � �year � " � � -= •fiour-ofldeath -'' ` - ' street,'�tio�pitai„nrat � � " � - .- :' cl ,.� 4� i�C � .i :� .: i � .. :, .� -. . !, . i ''..: r,. Age at Deatfi.' 74 ..Sex �'tqale � Coloi !: Whi.te t; .� Marrled - �; , � � y. � : , - � . . :�,--- . _ � ' -„ ,,,. �}ears � � .., � .•.��;� ,,«nte;whether married.or-single - � - �- .- _ .- .V_ . . _ 1 . . � t{ = ' �� -_. .. �.. .�;yt: � " Piamai�� cause_of deatti .given.w&3tlmonaTq emphvseb+s� �--'s — - � i. „ . .,. � � ., r. , �� `:� .' :,,_ _ _ _ � - .� . - . ,. . . - - - - - - - ,� .' ��- :�i ; S�gned by_ R•;-S;:�'!CE1TOy.�ID ' �Ex'-in4-8ton;_Ind.` ' - " :,�:Physician oi'coroner -` �`�-`". ' ' � =addressti . . .ir:-.-,�: �" _ - - Placebf bu��aL'oi iemoval + �I Q.Q.F � �FranciscQ,�n�. � ' � - • � _;. . i I � name. of cemeterv. : ' ' "" addre�s : -�. R .: - i' - . �. '„ _ _ ��_ __,�.. -_ - • •Date of bul,al�=9�2%�7;0 ?-__;;�-Colvin�& Son � � � .-' Pr�nceton; Ind.�'_ '__+'._ �_'_� _ _ � � � � Furieral D�rector =' _� � � ' � - ��' - � add - � � ' � � " i ' . . � ] , « � _ ' i e . - . i , � ' ' - � � 1 �_' . . . '' �'.; SEAL :.'" !i- ' .. , r .! , � ": Signeil � ~ .w �4r Q �%�li ' _ _� -`. �_ � i � � � -� ' � � � _ � G�6s n ounty.�eahh C�mm�ss�oner � : . q .i.. .7 � � - � ;�- ;� �� : -�: -� �. ..-. �� 1 1... �� t 7�' .� . �-� . ' � I_.�. � :.� : .. . �` � . .. , ' ' :��:. r.__ , Pr��cetor�. �. 4%5/73 - - .. 'r � � � • � „ � � .addmss � � . � � �, Date � , � ' `, t • .' �'4 ' . , .. ,' ' '�. �. i .'i � Recordedlocall}_ �n 600k�\*o 8 •�Page_No _—i5 F�Ied": 9/Zg/7o —'� � :rT.� :i;� �I. .f: ' �' ' i — : _ '_ - . ' t i ��' � � + � -F v ' + � r r ' � � � � � � ' � { � � 1 `� '\��.f��• � �.��_ -.. . �.- � _ 1 .. ,.{.� � 1�_ . , . ! :�.I: .�1. ��I 1 .{;. •'. .. _ _ � � . .: _. _ I�. .�" i.'. � 'f: t�_ `� . •" _.�..��" . _ ,� �r_ 1_'� . • _ _' � �i 1� .it�" � . . _ : ..i' —. :s.�' .. ._.. -=..i.�_. � ..i_ .. . _�i! . v.i��..... .� .. � _ '...:1 ._�! � _.. . _. . �. �_ '::.