Death Certificate - Stone, Lula_5/27/1976_ItF.CORD OP DE:1TH �
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GIESON COUN7'Y D�Pr1RT\[ENT OF HEALTH
rxi�cETOx, i�ntava
THIS IS TO CI:P�TIFl, tliat ou:• recoi•ds sho�c LULA S'iOT•?r �� died
. 5/lrl/197b at 5�20A?�i Owensville C4nvalescent Center OwPnaviilA�
- � month day year hour of death street, hospital, rural ,
Ind.
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�ge at Death gli Se�—Ee?!+31Q—ColorSv�hi�a\Iarital Status �'�idowed
��ears «�rite whether married 'or single
Primary cause of death given «�as °"Y�cardial insufficteneV ' "
Sib ed Uy G. 0. °jic.ker?son, DO OwPnSV111P, Snd.
pncsicinn a• cormier atidress � � � �
Place of Uurial or i•emo��r�l Clark Otcensville, Ind.
name of cemetery address
Date of buri;il S�� ����' jolder r'uneral Lom= OwenGtTi � � P, TnA .
Funeral llirector address
sr_��
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l,(� vi��%�`� =C G �L�� � .�� . .
Signed � ' "
Gibson County Health Commissioner
Oakland Cit.y, In�i. 5/27/75
address date
Recarded localic in book No. �-�2 Page No.— 17 Filed: 5/1R/7Fi
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