Death Certificate - Hendricks, Cleve Glen_4/23/1975�_os.:��__.:�.�.��.
RECORD OF DEATH • *
- GIBSOAT COliVTI DEPART�IF,\TT OF HFALTH
' PItI\CETON, INUTA\?�1
; THIS'IS TO C�1.tTIFY, tliat oui• recoi•ds slio�c_ CL�VF GLc�d H�b1DBICKS died
April 11,_1975at 12�3oPr? xa j�3 Oakland. City, Ind.
month day year hour of death street, hospital, rural
Age at Deatli 6i Sez Male � Coloi• '•�hite _Tlarital Status Married
, � ycars � write whether married or single
Primaiy cause o:' death given was Netastatic adenocarcinovna of liver
SieiedUy Farl $. Antes, M.D. F.vanevi��P- In�3 I
. . _nhpsician or cornner. . . . _ . _ �j �ddrrss _ .
Place . of bm•ial c�r removal Cup Creek ( neap � 1At1�rg�� , 7nri .
name of cemetery ' ` nddress •
Date of burial!� 14 75 �n�n M9�tua,�r ��klan3_ ��t�, Inci
' Fnneral Director address
�
* SEAL
i'u-"���/�' � ` /%�
Gibson Countp Health Commissioner
Princeton, Ind. 4/23/�5
address . date
Recorded locall�� in book No.—H–K� Fame No. li Filed: li����[