Death Certificate - Hargrove, Edna M_1/27/1971LOCAL � DAVIESS COUNTY �
RECORD OF DEATH HEALTH DEPARTMENT
Court Hoase — Washington, Indiana 47501
THIS IS TO CERTIFY, that our records show ____________�'dna M, Hargrove ��
April 21, 1970 � 12:50 p.m. Daviess County Hospital
--------------------------------------- at ------------- ----------------------------
- month day yeaz hour of death street, hospital or rural
Age at death ___ 81 ____ Sex _femal_e___ rolor �ite_____________xidowed
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years write whether married or single
Congestive Heart Failure
Immediate cause of death given was -------------------------------------------------------------
�
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Si ned b T�onald L. Hall M. D.
BY ----------------------------------------------------
physician or rnroner
-- -^ Cro-an Hill Cemetery
Place of burial or removal____________________________________
; ^v" � _ : � name of cemetery
Petersburg� Indiana
address
Indianapolis, Indiana
address
/1pri1'2l�� 1970 ?„O.D. Harris & Sons Petersburg, Indiana
Date of burial -----=------------- ------------------------
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: � _. - � 'F4neral Director address
�' � �. - — - ,-e_ �Q
_ � � — ° Signed: ��'��L��/� /J-=--- ---���--�'-�-
� �5'�'�__ ` Daviess County Flealth Officer
� ' -� ` COURT HOUSE — Washington, Indiana 47501
- \-.
Recorded locally in book No._�!� _18___ Page No. __ ��_____ Date ____ January 12t_ 1971 ______