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Death Certificate - Witherspoon, Glen_10/8/1975e li _ � . _v_ _ . __._._._.__..__.___�.._..�. _ LOCAL CERTIPIED RECORD OF DEATH CITY-COUNTY DEPARTMENT OF HEALTH City of Evamville— Vanderburgh Counry ' � Evansrillq Indiana �iO � 8958 F This ii to Certify, that our rccurd;;ho�v______________�ir.�`` �. '';I`i��3Sr00'V ----------------------------- died -----SEFT.------18 1975 °'1i5 }'.i•1. td�lborn f3artist _________yt..r• e[h________________________________'_________ . . month "'_'_'___"" de9 anr u( death aveec. haenitel er rurel .4ge at death---�Q-- Se.r_ r��]e -c- Color ��h•------------M?�Pi_ed � � ".' . ----------------------------� jP1f ' ' write w�hether marricd or sinQle Consestive heart, failure — art�riosclerotic heart disea� Priman� cause of death �iven «�as_____________________ -- - - --- -- - - -- --- ------- - ---- --- - --- - ---- --- -------------------------------=--------. . - M 5. i•tiller C� Signed by ----� -----------------------------------itV . . � phyaician atx_p�a�p� . - - - — -- ---- ----------------- nddra� Pl�cc nf burial or remo��al_____J°rE_e'_ Fa'okel Ind, ---------- -'------------------=-------- �amr or ��„«err � saa.m. ° '2 75 �olvin r^rinreton, Ind. Date oi buri�l -' ' - ------- -------- ---------------- j� '------------------------------- �//. �/�.c'!i►C/'�s�[ol�l�p edJra� . � Si�ilet� _____'_________ KP�IStiBf. ... ' " ___________ Evansville, Iiidiana �-�t�-'IS [SEALJ ----- ----dece -------- � '_ Ll� '_ NOTE: kecorded Iocallv in Book \`o. -------------- p��e.No. _- -------- � --• FEE $2.00. �_