Death Certificate - Dugan, LeRoy_9/14/1979RECORD OF DEATH +
•
GIBSOAT COUNTY DEPARTD'iENT OF HEALTH
PRINCETON, INDIANA
THIS IS TO CERTIFY, that our records show LeROY DUGAN
8/13/1979 ar iPM Good Samaritan Nrsg. Home Oakland City, Ind.
month day yeaz hour of death street, hospital, rural
Age at Death 91 Sex M' Color �• niarital Status Married
years write whether married or �ingle
Primary cause of death given was Congestive heart failure
Signed by Wm. E. Dve, M.D. Oakland City.Ind.
physician or coroner address
Place of burial or removal Center Rid�e Sullivan, IN
name of cemetery address
Date of burial 8/15/79 Corn Mortuary Oakland City, Ind.
�neral Director address
SEAL
o �Gr>G��z �° � � .�.�
Signed
Gibson County Health Com ' sioner
Oakland City,Ind. 8/23/79
address
Recorded loc�lly in book No. H-5� Page I�'o. 57 F�led: 8�z2�79
date