Death Certificate - Roush, Essie_4/9/1980. � :���-'��:.
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• 3 RF.CORD Ob' DEATH
; � GIBSON COUNTY DEPARTriLNT OF HEALTH .
� � YRINCETON, INDIANA
; � TfI1S IS TO CERTIF'Y, that uur records show ESSIE M. ROUSH ���� I
}�Zf78 8t 4�10AM Gib. Gen.Hosp. Prinoeton, Ind. ;
month day year pour ot death —
.. � - - ecreec� 1�oapical. rueal - - -- - — -
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� Age at Death 86 Sex Fe. Color �• Maritat Status Married
� y� write whet6er married or eingle
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Primary cause of death given wa.a Congestive heart failure
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Signed by William R Wells MD Princeton, Ind
phyaician or coroner , address
Plnce of buritil or i•emovnl Mont�omerv Oakland City, Ind.
name ot eemetery addfeas
Date of buriat 5/4/78 Iamb Hedges Memorial Chapel Oakland City, Ind.
Flmeral Dimtor
SEAL
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Gibeon County HealtL Co ioner
Oakland City, Ind. 5/16/�8
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locally in book No- 9 r8ge No_ 63 �1ea; j/16/78
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