Death Certificate - McCullough, William Null_8/8/1966LOCaL •
RECORD OF DEATH
CITY DEPART1fENT OF HE9LTH
PRI\CETON, INDIANA
�
THIS IS TO CERTIFY, that our records show ,'.'illiam Null TicCullouoh
died
July 29 1966 at6:30PM� Somerville, Indiana
month da}• year � hour of death stmet, hospital, rursl
rlge at Death�Z—Sex Ma� a Color?iihi ta Nlarried
� years � write whether married or single
Primary cause of death given was �:cute riR�t congestive heart £a.ilure
Signed by Howard ri R�i �� n.0. " Oaklarid' Cit'y, Indiana' - -_'
� physician or coroner � address
Place of burial or removal S'omerville Cemeterp Somerville, Indiana
name of cemetery- address
Date of burial 8-� -66i Gorn hinrtuarg Oslcland Citg� Indiara
, . � Funexal Director ' . " addmss
Filed: 8-2-66 �4� �� *�� Y
SEAL' Signed �� � � 4ec .
__. _ �4�, �^ � _ ,- ->. . Princeton, Indiana Au�ust 8, 1966�
— � address , date
r
Recos•ded locally- in book No. H-C� Page No. 88
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