Death Certificate - Sullivan, Harold_5/23/1977�-N
LOCAL `' "-' -'
RECORD OF DEATH
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� Dr1S'IESS COUIv�'I'1' ,�
HEAI.TH DEPARTMENT
Court House — �Vaslungton, Indiana 47501 `
THIS IS TO CEATIFY, that our records show _____
Harold Sullivan
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----------------------- died
1-19-77 12:l�8 p.m. Daviess County Hospital
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mon day . yeaz hour qf death sLmet, haspital or rural
62 male white married (i9artha Snith)
Age at death ___________ Sex ___________ color ______________
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. years �vrite whether married or single
Skull Fracture
Immediate cause of death given was ------------- -------------------------------------------
� pccident: fell from walk plank at Indian2polis Power & Light
Petersburg�Indiana
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Si ed b H.O. Norton M.D. (Coroner) S•Iashington,Indiana
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PhYsician or coroner --------------------------
2(I(LiCSS
Scottsburg:Cemeterp Scottsburg�Indiana
Place of burial or removal -------------------------------- -- -- ---------------------------------------
� name of cemetery . address
Date of bi:rial __1-22-77_________ Ste�rart Funeral Home Scottsburg�Indiana
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� Funeral Director address
. . .Sla12C1:__ __1_��_eG�__!____`�%_`_�- _'l__"�____"_
S'�+'� Davicss County Heaith OHicer
COURT HOUSE — Washingkon, Indiana 47501
CH-20 6
Recorded locally in book No.__________ Page No. __
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2-�0-77 I
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