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Death Certificate - Johnson, Ellis E_9/16/1981�r'-�:a��r.rq i� e�s....'1'�^�'�'t�+';; ' . . . � ', ' �- � . . . 1 . ,� � ��.� • .. • �� • "i » .� � . �. �� r:;;y RECOHU OF DEATH ,i .� GIBSON COUNTY DEPARTrIENT OF HEALTH � - ' PRINCETON, INDIANA ir . ;� iLij lj TG CFRTIF'Y, thatour records show__ ELI,7� E JOHT�icnu -` � � died �li ;.�� 6/�8/69 at 5PM Gib. _G_en.Hosp. Pr;n eton. Tnd. �, month day penr � hour of death � stmet, hospital, rura) . , Age�at Death 64 �ex M• Color W�liarital Stutua 3.�� m _ � write whether married or .ingle �• ! ' Primart• cause of desth given was Cardiar arrest ,. t ' Signed by_ ' Virgil McCarty, MD Princeton, Ind. ` '� j' phyeician or toroner addreea �}.t Patoka, Ind. .,.,f Place of burial or removal '. name of cemetery nddmsa � �. "''� ♦ - 6/3�/b9 - Colvin & Sor. T �'.!' ��Z� u�1LC �j burial Slll(:C Ll%il� lj]Q ' � i:� . '�II1878� . . �l19C�0i 8dQ1Y88 �'`�. yA � � t / . '. �1 d \ . • f s;sn �ii� �t � �� ; ..' SEAL . , iy,�j � t.. � n• Gibson County Hea(th Commi ner ' : ' 1 �` k� �:•� Oakland City, Ind. 9/16/81 ` Ei edmpsa �� „;� :� - . `<. Recorded locally in book No- � page No- 262 �i�; 7/2/69 :;{ :.: ; � . ..,�. ��., . .- . _ � , ! ', _ - _ . . ef . . , . �.� _ , � i ' :.. _. ._._ ' . , , ' ' . . " ', ; . � • � � . � . � ' �. ' ; '. � .. .. . . . . � � � ! , ��1' �, . . I . • . . . ' . . . . .. � / . . ' . . - , . , ' . ' ' , . . � � , . , ' ' ' '. ' ' . � ' ... � . , . . . �. . ' . . . � " ', • • ' i . . ' .' . _ � � � ��.� . . . ' . � ..� � ' . .. . . .