Death Certificate - Gentry, Roscoe_1/27/1975�
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RECORD OF DEATH . � . •
GIESO\ COU\TTY DI;P�IRT\IF..NT OF HEAI.TfI
PRINCETO\�, I\DI�1\A
THIS IS TO CERTIFl, that our records sho�c' ?i0SC0E GEidTRY died
Tan. 21, 1975 at 5�3onM Gib. Gen. Hosp. Princeton, Ind.
month da}- year hour of death street, hospital, niral
Age at Deatli 79 Sex �le ' Coloi• White _JIai•ital Stltus P4a1�2'led
pears �crite whether married or single
Pi•imai•�� cause of death gi��en was Small bocvel obstTUCtL4fl
Signed by A. E. WeltzfllTM.D. _PS111Cg�9a_�___In�.
phpsician or emroner address - �
Placc of Uurial or remocal_ Shlloh BockpoTt,_ Ind.
. name of cemeter}� address .
� Date of bui•ial��/75 Boultinchouse_527 Msin` Rookport, Ind.
Funeral Uirector addreas - �
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Gibcon Count}� Health Conunissiuner
Princeton, Ind. 1/27/75
address
date
Recorded ]ocall}� in book No. 9 Paae No. Z Filed: 1�?%�%�
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