Death Certificate - Moll, Henry_8/18/1976RECORD OF DEATH •
i3_ �'� •
GIBSON COUNTY DEPARTDIENT OF HEALTH
PRINCETON,INDIANA �
THIS IS TO CERTIFY, that our records show IiENRY !�!OLL died
Jan. 24, 19�4 0�'�(1AM gR�'t T�ranch, InrJ
month day year hour of death street, hospital, xural
Age at Death 68 Sex Male Color3�ihit��farital Statuc Marr1 nd
yeara write whether married or aingie
Primary cause of death given
Signed by B• C. GwaltnC�v. MD F'
physician or coroner a ss
Place of burial or removal
name of cemetery dress
Date of buriall/27/44 G�np�g ,� t„�a� Haubstadt._ �Tn�
FSineral Director address
SEAL
� �i'� 1 ./.��%"� !r . �l�? ( !�l ,('
Signed �
Gibson County Health Commissioner
Oakland City, Ind.
address
Recorded lceally in book No. A—�'4 page No.-2?6 Filed: 1/9R/44
date