Death Certificate - Burton, Theodore (Ted) Hamilton_4/6/1978� �- , '
RECORD OE DE:�TH
; .. .. . .
-• - GIBSON COliNTl DEPART�iENT OF HEALTH
� PRI\CETON, I\'DIAN.� '
A . ' -
THIS_I5 TO CERTIFY, that our records show' THEODORE (TED) HAN!II,TON BURTON diecl
2/.3/197$ at 12.�SPNi" 6Virth Hosp. 'Oakland City, Tnd.
month � day year hour of death .� street, hospital, ;ural � � �
�ge at Death 80 Se� M' , Color Wh' lfarital Stntus Married
� years . . write a�hether married or single
Primai•y cause of death gic�en «�as Cardiae arrest, acute; Pneumoconiosis
Siened by . H. A. Peters, DO Oakland City, Ind.
ph}-cician or cqrmier � _ address �
Place of burial or remocal Forsythe Oakland- Clty, Ind,
� ' � name of cemete�y address � � ' �
Date of. burial 2�6�78 Corn Pdortuary Oakland City, Ind,
� � Fvneral Direc[or address - � � � �
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� 1 r 1"�''',. :' `i,. ii,�� /`:'..
C-f / ��r �'::=,`="� 'i�.� -�._�_
SEAL Signed
� Gibson County Health Commi;sioner � ' -��
Oakland City, Inn. 2/9/�8
� -� address � ' � � date
Fecorded locall}• in Uool: No._._—.H=S�_Paae No. 3? Filed:_—�8�78