Death Certificate - Beloat, Ralph M_11/21/1990G I B S O N
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COUNTY DEPARTMEN'S'
B00 S. Prince. St.
Prinr,eton. Indiana 47670
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RECORD OF D�ATH
O F H E A L T H
THIS IS TO CER'fIFY
that according to the records of the Gibson County Department of Health,
RALPH M BBLOAT
nied on 09/29/1983 at 8:45p
Gibson General Hospi[al
1808 Sherman Drive
Princeton IN 47670
Age at death
Cause of death
Signed by:
71 Sex: M Color: White
Acute myocardial infarction
Honesto K. Fenol, Jr
110 S. 6th Street
Petersburg IN 47567
Place of burial Owensville
or removal:
Owensville IN 47665
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Fiineral home: ' `
Holder's Funeral Home
� 319 S. Main
� Owensville IU 47665
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S E A L
Marital Status: Married
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Signed by ------- �''-
Gibson County Health'Commissioner
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Oakland Citv Indiana. 11/20/90
Address Date
Recorded localty in Book No. 10 Page No. 101 Filed: 10/17/1983