Death Certificate - Potts, Joseph Henry_5/10/1976���; � - -
� RECORD OF DEATH �
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GIBSOAT COUNTY DEPARTIIEI�TT OF �iEALTH
PRINCETON, INDIANA
THIS IS TO CERTIFY, tha± our records show JOSEPH H�?F.Y POTTS died
'''. 4/17/1976 at 7�30PD� Gib. Gen. Aosn. Princeton, Ind.
,� ; month day � year hour of death � street,thospital, rural ' •
Age at Death 73 Se�y Color''�hite nlaritalStatus Marr1PB
� years write whether married or single
' Primary cause of death gi-�en was Fneumonla b3se of both lunas
Signed by A• S• h!cSlrov. M.D, Princ�tnn, Tn�l.
physician or coroner address
Place of burial or remocal [dhite Church Prinr.Pton TnA.
name of cemetery address
Date of burial 4/2�/7h Colvin & Sor. Princeton. Ind.
�neral Director . address
SEAL
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(,v Ls=,� �r�� � ` � �.�
Signe
Gibson County Health Commissioner
O�kland Cit.Y� Ind. li/22/�h
aadress � ��¢
. Recorded lceally in book N�. 9 page No.— Z4 Filed: �/2�/75 � .
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