Death Certificate - Stone, Olevia_8/10/1976RECORD OT DE_1TH
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GIBSO\T COUNTY DL:PARTIIPNT OF H�ALTH
. PRINCETON, INDIAN�1
•-THIS IS TO C�RTIFl, that our records sho«� OLEVIA ELLEN STONS died
11/9/1974 M1t 9�25AM Owensville, Ind. Convalescent Center
month da}- }-ear hour of death �� street, hospital,�iural
�1ve at Death 80 Se� Female Color `+ihltq�qarital Status Marrled
cears write �chether married or single
Primar�- cause of death given tsas—�An¢�ct1vP hra'rt. failnrr
r
Si�ned 1;�� R._G_.�Sck�tlD —�t.-3ranrh- Tnd.
physician or coronm� address
Fiace of Uurial or i•emo�al 3lythe Chaoel Owensy_S�le, Znd.
. name of cemeterc � address
Date of bui•ial il/11/74 Holder Funer�l Home Orrensv�lle Ind.
Funeral Director address
SEAL
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Sib ied �
Gibson County Health Commi_ oner �
Oaklan�l City, Ind. A/10/�� l
address date
Recorded locally in book No.�_1—Page \To.?� Filed: 11/19/7w
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