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Death Certificate - West, Roscoe_7/5/1975� -- — ------- --- -- - - - - � ---=- ---- — ,. -=• V,• � . .,'� ' _.. / 5 PIKE COUNTY DEPARTMENT 0� HEAITH , �:_,, . .�_ , PETERSBURG. INDIANA RI:CORD OF . Dti:1TIi THIS IS TO CERTIFY, that our records show — _j C _ � j,�� :� / G: %1�, ac mon day year hour %�' %y'��l%�.% age sex color � - ""� Primary cause oY death gicen u•as — / Signed by /• /i' 7 ; ,Physician or Coraner /, A O 7�� hospital or rural mmTied or single ^I address �C ')`r ��S_/�[L��/, died �� place of bunal � cemeten� - a�� ( i/ / � Gl.C. t.. � . / �c _—_� � �7 .?fi�.F'Li� J O Ai 5 �G. Tt',�Sh f i ci �/LY � date. _° bunal funera] director address �� Rewrded lecally in book No. �i� -- page No. �� n ,; Filing &'tte �J-1� [. �'" / `��-� � Signed • ' �'�w� — � Pike Coun[y Health Conunissioner Petersburg. Indialm Dnte `-� % � n' C- —�+ � �� -� 9 ��rr�nt� �pr� � �his �ni�enTure 3�iinesseil�. . � � � "� -- - , , - '�"hat D!:,;ii,�i� dGl�iA;?i, 2r.c? �O_..d .... riOLVA�:D, RU.SAaRd and cvife of F i?:e Convr.v and fi''nrran� tn Pilro 0 Coiartc, in the State of j�d i2� a � ��,-..., ';r-� -• a 1 ; n — i�.^^ Gt� � �. .��v,. ,r.S_ anu 11AN ;,-. :;:at;i;_ c�T. i:u....anc and of Gibso❑ Count}-, in the Staie of j�`.Gra , for and in consideration of TRLi �V—i1V6 �un��re�� FifL�, �JO! 1.3i'S �Z ;'��,L`;� Dullars, the receipt n•hereof is hereby- ackno�cledged, the follo�ring described R,�a! F,srar� in GibseR Countc in the State of Indiana, to-w�it: _. L,Ot i�21t �;RQ flitj� 1P.C.'C Oii �fi2 �-'HS� CfI��S ..: L.Ol.S ;^,ti;:iD?i' IQ� 20, 21, 22 and 2� all in John �ichardso� �.dd:tion t; ti�e torvn �f Oaklaed City, Inciana. , JT✓?T� �7rc 3r-t i�iR"I�'�Tt�^�. +,O �.�Ti3Stlirr ri+� �I � ' - �" � � �._,_� � �_ ;�;6 �`l ;j��"' �� '7 ,� �� i��t� " ,:;s%��; --- ��,�,�� '��!],�.-.�� Y lU�'� t(lt��T - - - -��s._ - '-jj�t''..li'�71^i: �rll� tiR'f7 �` iT:i�l _ .•'ICt�Li:L•5i`ti? � -• �.n} ..a r- t' �'i�� ..� r •� r It[ ��> li�� , F'` :�it%Ii �,� ;" A ��tll �� a '�� , '. � �_,►�.-� IO �.,_ , "� 1( )t' '' .�.Jri.r.::i:Ja . ti i ��r.3,�'",..1i� `�'ti�++'�'"vr'r-'� �R ;.J'r��rr- ,—,r,� ��Ji,�rn^�r ,,i ti T+�uv�of�i� . �.s ', l� 6� ' + � ;c ��, e��/. t --.� �'� !y rlY � t ��Y !i �� ?� �-s�i �� . R ' � LL g " 1 '�>� F �=��ie'S>�' �9 � �� 4 \ : � r ; i�: -7 ��`��: _��-r��.'�� :••��•_, �'� � ��;� ;I z- .?Ill;��: � � � �.� r'� �� . :'a;',,- 4 —�..= -:�=,— _ �3� � _� � �¢j�'�rrs'�t. In R�i[ness R�hereof. The SAId nusbanc! and w±Fe �er.nis riemar4 Gnd Cora I.':, Howarc:, ha v9iereunto set t i1e i t]�anil � and seal =, this .2 9 da}• of 1,.�,1,L q,cLC�C� 19 �?. ( f r . . _ ,