Death Certificate - Mounts, Joe H_8/21/1981R�CORD OF DEATH � • `
GIBSON COUNTY DEPARTI�4ENT OF HEALTH
PRINCETOY, INDIAN?.
TIiIS TS TO CERTII�Y, that our records show �TOF. HFIHVEY �OliNTS
12/2.0/79 _at_ 1:1
month day ycar `hour of �IcaC
�3 Owensville, Ind.
strect, hospital, rural . , .
�
Age at Death 6`Sex M' Color wh' Mai•ital Status._ M'
yeats _ � wrife whether manied or single
Primary cause of death given was Coronary thrombosis
Sisnedby_ Bobert �. Stodghill,"Coroner Ft. Branch, Ind.
. � physician or coroner addiess
Place of burial or removnl Benson Owensville, Ind.
� . � name of cemetery . . address �
Date of buria] 12�22�79 Holder Owensville, Ind.
� F3ineral Director � address � �
- SEAI. '
Signed "" �t � ` ��
Gibson County Hentt6 Convnis er
Oakland City, Ind.• �8/21/8T,
� `� ' aaar�� .. aa�
H-52 61 12/z7/79 '�;'s�—'k"... ���},�� r�
Recorded locaily in book No. Page No. �led: __ �_— --
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