Death Certificate - Couch, Eugenia Louise_5/7/1975'yl',
I� oe
I� °
i�
"� o
o., ..
t_ �'- -
o '.
:�
�
a
o`
�F
RF.CORD OF DEATH � •
GIBSON COUVTI DEP3PT\IENT OF HP:ILTH �
PIiI\CETO\`, INDI.4\A ' �
THIS IS TO CF.}:TIFl, that our records sho�c �ILGr,ATTA rn•rrec n.,..EF� died
—JulY�2�12s9—at fi � �na r✓ Cncgnsv+ �� e �n�
month day peaz hour of deaih street, hospital, rural
9ge at Death_ 40 Se� Fe• Color Wh• \fai•ital Status Married
years �vrite whether married or single
Priro:u�}� cause of death given �vac Rheumatie heart dicPase
SI�uCCI L>y _ Ra mnol r.Ai i ep � n�g Owensvt � � P. In�' .
. . .yh���icisn or _crocar -� nudress - � .
Pl:�cc of burial or remo��al 3ethel Owensville, Ind.
❑ame of cemetery � address �
�Datc of bin•ial__
' SEAL
Short & Holder Owensville, Incl.
F4�neral Director address
Recorded loc�lly- in book n�o. x-46
I/'�� � i
�4l.�`4%��7 rl� ��� �%i`Q
Gibson County Health Commissioner
Princet� Ind. -4/22/�5
address date
\To._� Filed : 8 /2 / 5 0