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Death Certificate - Hollon, Jennie Lee_11/15/1976�f :' �c � �j S �„ 1 t � � f�. q �� 1 � �i r k�y fi �. i r A'� [9 t�� '. aA ' y��'u ��1b ''� >..7 �.rl V7�� , .. �� h .�' 7'>.. .475 .��i y� � � � �F s I �.l f .'J i % n .V. ry , rt Nr �%n�( t i � t! , ..• t� �t1' ".�' 1 �(� � ".;11 M1, + � � �C� � ' � . r ..r . � �. i4 . ;! { .,�.:-. .'., i . ��. .� ° J�.�; ° � �' e .r.-..'„ l ` r � .;' 1 �� . < C. v 5 rr y �t ~ti��` ..r'� e � {� .C., }- 'f , , ..] r: i �.S I G � ". � ' ! 1 .' t ..v � _ l��I, y 6,...�" ` `_ r 5 �� .. � , �T...,� . ! it ,. t }�`�, } -� ' r . w � - tn� ` i 'i�. �' �� ' y r � ;'� - i F ..� �. . n. * � n � � i �i. ��h V .� , f __' �. �.._..� `` r ,i �`` ' } �S ,� � , < ,v,��h ' � � . r..:.�x,.... `'yri..��. _r.. ` _ ..l�.s—�_ ' ..._ ..�L.._ . 'L _ .r!..��_ �_��3o_...i._-��L i� . ' f 6 . . . . . . . ., . . . .. .._.._._. � M1 z : o-. � � � . � . . . . , . . . 9 � YY"�,5� f n� � . . � . . � . ' . . - , . . . . � � . . �' kz `v RECORD OF DEATH ' . • ' . N5. 1 � �11.. . . . . . . � y' `' . C]I3SON COUNTY D�PARTMLNT OP 11�AT,'CII ' , ��.. , _ ''s` . ��'•; . � , � i'RINCLTON, INllIANA . � � � - ti;.._, . . . � . �. ... _, TIIIS 1S TO CPRTIFY, that our records shOw JEN�IIF �F u�TI,{Z�T �i�� ',, . . . ,, . , - -;�; �: -. ',.= "i.: ,,�. . A i- 'y° .. . �. . � s • �'. Vf:', i � ` 'r'� . =:�;:'y w ..��- .,. . . -fi�. . _ -. . l.1/�k/1.975 ;lt l^�1_r�.h_r"_emnr�al �rpg-n.— �akland ;C1tv� Inrl, - month day ycar hour of dcath strect, hus�iiLal, rural - Age at Death 75 Sex_Ee.. Color�h._11'[ariLal SLntus ' �farr;P�7 years � , , � , � . ; writc, whether murried or single Primm•y causc of deuth given was Acute car.diovascular co11�3pse i S;gned by �erald GraY. DO _p��-_��.� � , �Ihysician or coroner ad�ress. . Place of bw•i:il or remov�il MA��mary � Oa�tlann 'C, i t V�� Ind . name of cemetcry address ' Datc �of bui•ial�[./76 T�mb-i?edrzes Memorial Chapel..= Oakland Cit,y, Incl . Ilineral Director - � address- ' , i • / � . . . Gv��U�� .. �� ,��, SEAL . . Signed ' • � � � ; � � . .GiLsonCount;y�,Health�Co issioner . i - Oakland Cit,y, Ind. ].1/15/7h � _ .. � � , . _ _ address ' , ' . �u, . � Recoi•ded locally�in boolc�No. � H-5� nflgc No._ zl P'iled: I. . / •J /I4 �( 1. ) t �� ... �.� M ��. y ~ � lY Y. j1�V . � ` � 1r . . . . .._.._ . . '� • . � Y- K 1< � R 1 4 ' tt 1 � i t � ..6. � _,: il/i;/76 �•Y-Ci. nr.`S '�.�1.: {i k : ! 4 � ♦.�. ? y :��••': . - � e . ... J`. , .�� 1!^ �c ... �.�, L '.��. . ,.