Death Certificate - Cleveland, Matilda C_5/19/1999GIBSON COUNTY DEPARTMENT OF HEALTH.
• 800 S. Prince St. • �
Princeton, Indiana 47671,
812-385-3831
RECORD OF DEATH
THIS IS TO CBRTIFY
that according to the recorde of the Gibeon CounGy Department of Health,
MATILDA C. CLEVBI.AND
Died on 04/29/1999 at 2:10 AM
Oweneville Convaleacent Center
Hwy 165
. Owensville IN 47665
Age at death . 93 Yeara
Marital Status: Widowed
Sex: F
Color: white
Cause of death: Atherosclerotic Heart Dis=ase
Signed by: Cheeter Burkett, M.D.
P.O. Box 550
Poseyvi�le IN 47633
Place of burial Mount Noriah Cemetery
or removal:
Dnte of burinl:
Puneral home:
S E A L
Ft. Branch IN 47648
OS/02/1999
Holders Funeral Hor.ie of
Gibson County, Inc.
P.O. Box 518
Oweneville IN 47665
S igned by _ W ��R"T7 � � "`/&'s''p
Gibson County Health ommissioner
Oakiand City Zndiana 04/30/99_
Addrees Date
Recorded locally in Book No. 13 Page No. 92 Filed: 04/30/1999