Death Certificate - Schrodt, John F_2/6/1976RECORD OF DEATH
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GIBSON COUNTY DEPART�IE\TT OF HEALTH
PRINCETON, INDIAN�1
THIS IS TO CERTIFY, that our records shoµ� JO??DJ F. SCEFODT, SR. died
Jan. 14, 1976 ar 3�5oPrt GSb. Gen. Hosp. Princeton, Ind. '��
month day pear hour of death street, hospital, rural'
Age at Death 75 Sex Nale Color���hite �I�lrital Statue hisrried
. years write whether married or single
Primary cause of death gi��en �vas Gastro-intestional hl aP�i 1 nu-iil r.Pr
Signed by �• F• '•�eit�el � M.D. Pr1nCAt.CR'1, In�'
,_ _ _ . physician or coruner address
Place of burial oi remov:il Antioch xe��S�y��.m� r}i
name of cemetery• ' address � �
Date of burial 1/l�ij76 CnnninQham Fnnc+�� u.,,o;;�� 403 Cherry Tdr. Carmal _ 7ll _
Fhneral Director address
SEAL
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Signe � � vY� ..�=: �. �. c` /.C: c -
Gibson County Health Com issioner
Oakland Ctitv, ���7 l-/21/'75
address � date
Recorded lceally in book No. 9 page Aro.—l�Filed:-1�21/%�