Death Certificate - Bottoms, Welza Samuel_4/27/1992�
G S B S O N
� �
C O U N T Y D E P AR T M E N T
800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
R E C O RD O F D E A T H
O F H E A L T H
THIS IS TO CERTIFY
that according to the records of the Gibson County Department of Health,
WELZA SAMUEL BOTTOMS
Died on 03/22/1979 at 1:15pm
Wirth Hospital
Awy 64 West
Oakland City IN 47660
Age at death : 76 Years Sex: M
Marital Status: Married Color: White
Cause of death: Ruptured aortic aneurism, (acute)
Arteriosclerotic Heart Disease (years)
Pneumonoconiosis
Signed by: Henry A Peters, DO
Hwy 64 West
Oakland City IN 47660
Place of burial Somerville Cemetery
or removal:
Samerville IN 47683
Date of burial: 03/25/1979
Ftmeral home: Corn Mortuary, Inc.
323 Y. Main Box 278
Oakland City IN 47660
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Signed by ��'/ `�"�j?�""�� �h+�
Gibson County Heal C�f ommissioner
Oakland Citv, Indiana 04/23/92
Address Date
Recorded locally in Book No. Page No. 52 Fi1ed: 03/29/1979