Death Certificate - Bilderback, Clemmer E_11/13/1986RECORD OF DEATH �
� _ .r,: v. .:_... ` �..
-' -: GIBSOAT COliNTY DEPARTDIENT OF HEALTH
PRINCEfON, INDIA\'A
'PHIS IS TO CERTIFY, that our records show CLEMMER E. BILDERBACK died
November'1,1986 at 9:45 P.M. Gibson General Hosoital Princeton. In.
mont6 day year hour of death street, hospital, rural
Age at Death 76 Sex Male ��or White M�tal Status Married
years write whether married ox single
Primary cause of death given }��as_ Metastatic Adenocarcinoma ( several months) .
Signed by'
William R. Wells, M.D. Princeton, In.
physician oz coroner
addresa
Place of burial or removal Aol �(`rosc Ft _ Rranrh , Tn _
name of cemetery address
Date of buria� November 4, 1986 Stodghill Ft. Branch, In.
Flmeml Dizector
SEAL
address
Signrri :'f%U��72G. '�'16���
Gibson Countp Health Co cioner
Oakland City, In. Nover.mber 10 19R6
address date
Recorded locally in book No. i1 page No. 26 F.;��; November 10, 1986