Death Certificate - Scott, Ada Mae_5/31/1984j - -
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RECORD OP' DEATH
GIBSON COUNTY DEPARTMENT OF :-'.°ALTH
PRINCETON,INDiANA
�J
AD:4 MAE SCOTT
THIS iS TO CERTIIP Y, tihat our records show ___ _ died
5/9/84 ,�t 1:45PM _ 929 East Ohio St. Princeton, Ind.
month dny yenr hour of denth street, hospital, rural
Age at Deat:h 60 SeX Female Color �ite T7arital Status � Married
years writ¢ whether married or ainglc
Primary cause of denth given
Acute cardiac arrest, immediate
Signed by Gerald Gray, D.O. Oakl.and City, Ind.
phyeici¢n or coroner addreas �
Place of burill or removal Columbia Church Princeton, Ind.
name of cemetery address
Date of burial 5/12/89 Kendall Princeton, Ind.
` �� � Funeral Director ' address
� SEAL
��F'/�i��-�e,sb�
Signed_ 0
Gibson County Aealth Commiaeionar
Oakland City, Ind. 5/21/89
uddmas datc
Recorded loc�tlly in bool< No.___ .� � Puge No.__7 20 1; il�,� : 5/ 21 / A 9