Death Certificate - Sisson, Roy A_3/20/2000GIBSON� UNTY DEPARTMENT OF HEALTH
800 S. Prince St
Princeton,.Indiana 4 0
- 812-385-3831 . -
RECORD OF DEATH
TSIS IS TO CffitTIFY
that accordiag to the recorde of the Gibeon Couaty Departmeat of Health,
ROY A. 32380N
Died on 09/22/1999 at 3:SOPM
Good Samaritan Nuieing Some.
210 Gibson .
Oaklaad City IN 47660
Age at death . 68 Yeare Sex: M
Marital Statue: Married Color. White
Cauae of death: Acute Pneumonia, 1 week.
Dementia.
Signed by: Terry C3ehlhauaen, DO
Hwy 64 West
Oakland.City IN 47660
Place of.burial Mount Olive Cemetery
or removale
Mt. Olympue IN
Date of burial: 09/25/1999
LPUaeral home: Colvin Funeral Home, Inc_.
S B A L
425 N. Maia St.
Princeton IN 47670
Signed by ����� ��
Ciibeon County.Health �uesioner
Oakland City, Indiana 10/04/99
Addreee . _ Date
Recorded locally in Book No. 13 Page No. 102 Filed: 10/04/1999