Death Certificate - Holderbaugh, Ida Ann_7/6/1976.�
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GIESON COUNT] DEP�IRT\ll:\T OF HEALTII
PRINCGTON, I\DIANA
TEiS ]S TO CEP.TIFY, that our records sho�ti� I?�� Ar.?.1� fipi.pER'�AUG ri �
11/].R/�� ,�t ?;7.Kp;.; Gib. Ger.. 'r'•osu. Frinc=ton, Ind.
month . day pear liour of death ,-sireet, hospital, rural �
Aee at Death ?P Sex—F-. Color—�:!_�\[ai•ital Status �'���}_�?
}'cars � �crite �vhether married or single
Primar�- cause of death gicen was3trial fibraillation w/acute con�. heart failu
SiLned b}- F.. S. i�'CS�roV� PT, Prince`�, Tnrl.
phc;ician or coroner � � addrzss
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Place of bui•ial oi• removal %�nite C}1urCh Frinceton, n"• '
name of cemetery .address
Date of bui•ial 11/?1/7a ��olvin .°.- �on Frinceton. Ind.
F�neral Director address
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Siened
Gibson County Health Commissioner
Oaklan�? City, Ind. 7/5/95
address
date
�r Recorded localh- in book No. R Pnge No._ 1 �7 Filed: 7.1 /?�/7li
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