Death Certificate - Bottoms, Claude Ottis_6/8/1979RECORD OF DEATH
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GIBSON COUNTY DEPART�IliNT OF HEALTH
PRINCEl'ON, INDIANA ,
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1'HIS IS TO C�RTIFY, thut our records show C7.Ai1T1F ATT74 anmTQht� � �;e�
_ F@b. i, 1977 at 7 s 55PM Ci h, Gpn. Hncg�_pri nratnn� TYyA
month day year Aour of death street, hoapitsl, xural
Age at Deuth 68 Sex M. Color �'�h. nl�rital Statu� nrt�rr; ed
y� _ wri[e whether marriod or eingle
Primary cause of death given was RespiratoTy fsilure
Signed by Wm. E. Dve M.D. Oakland C;ty rnd
physician or coroner address
Place of burial or removal Mont�;omerV Oakland C� ty Tnd
name of cemetery address
Date of buriAl 2�10�7i Corn Mortuarv Oakland City Ind
FS�nexal Du�e�tor nddress .
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S�gne� �; _.{
G�bsoa County Health Commieeioner - I
Oakland City, I�, 2%i4/�� I'
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Recorded locally in book No- 9 page No- ;i7 Filed:_�,/14�77
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