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Death Certificate - Tepe, Nettie_3/26/1968' RECORD-0F DEATH - - ,. � . • . . . � .i� :. � .
� '. � ' . . ;GIBSO?�T COUNTY�DEPART\1E1'T OF HEALTH _ � _
. . ; . . ,- -. ' . �. . .. .� .. _ PRINCETO\;�I\DIA\_4, : .- . � : '. � - " � � .
'.,EmTz L���T?��a ^FPF �
, TAIS �IS TO,CERTIFY; that our records show _ - , -- d�ed
- - . �' = -
- July 6, 1957 . at6:4$�PN-Gibson Gen Hosp�P,r_inceton;Ind:
' �. ' month� . ` 0a}-' � � � - � � �}-ear - �" . - � �hour of death � � , � street,�hospital, rural� � _
" 9ge at Death 5�', " Ses remale Color lJhYte • i•tarried _ .
. .. ., . . Years�.. . " ." . . . . " - �crite ���hether married.�or single,- � .
Primary cause of death given �vas ' � Con�estive Heart Failure• -
' Signed by = Will-iam'E'. nye-, �M.�:: - - : - '_ -Gakland �Ci.ty,.�Indi,ana;_. — - .
� ; � � � �-ph}°sician•or coroner - � . _ • ' . _' � address � . . � —. .
Place of burial or removal-Somerville � � - Somerville, Ir_dianG
. ' .. _ . . � name_�of cemeten= _ � � . � � _ address . �'� - - ; ! '
�..Date.of�burial 7-9-57 -=�orn 2; .Reed � . _ . O�kl'and City,, Zndiana. �
- � " � - - •� Funerssl �Director � • � � - � i�ss � � � � � ' n� '
• -`.SEAL~ . .. . � Sign�t/��'/� %i�,c%�YJ .
- .1 � � _ � , � _ . _ � � � � ... - _: � Gib�on,Count>-. Health CommSss�oner �
� � _ ��� . • � � . _ . . ' ' . PrinC°tOri, `1!1G�lana �. . u_12=67 . .
^ � -- ' - -� � - - address � . - . . - date �
,�. �% � .'4 � \.:�� . �. , �.� - � . � _ . . ..
. Recorded locallp in Uook \To. ' ' 6 � Page No' `- 213 - , . -
� .. � . � Fi-1ed' 7-20-57.. - . " ,
