Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
Death Certificate - Black, Ronald A_10/21/1981��.:�Q.�.....,.: -,._a.�.,. . .r
a
RECORD OF DEATH
..>
,
GIBSON COUNTY DEPARTI�fENT OF HEALTH
PRINCEfON, INDIANA
TIlIS IS TO CERTIFY, that our records show RONALD A: BLACK d
7/18/64 at 6:3oAM Gib Gen Hosp Princeton, Ind.
month day year hour of death street, hospital, ruzal
62 cex M• Color �' Marital Statua ' .��� �.
Age at Death write �chether married or sii
Y�
primary cause of death given was
Generalized Metastatic
° Wm. E. Dye, M.D. Oakland:Gi�.ty, Ind::
Signed by �, addresa �•3 <<
phyaician or eoroner , —,
Place of burial or removal Montgomery Oakland City;,;;Zrid.
- �me of eemetery ' �°`�"�L, addrenn �' '
�/20/64 iamb Oakland City; Ind. `:,�
Date of buri � .y; � : ;� �
bynera! Direetor . _ � eddreae
� z:
WiPe: Marie, Black . � �--_ . � �
� �� ���[ l�. ' �'7�
SEAL �$II
Gibaoa County Health Commi �or
Oakland City, Ind. 8/19/81
adareas �
Recorded locally in book No H-5� page No 5
� �ti�ed: 7/Z1/64
. ,
. ��7
