Death Certificate - Wallace, Bernice_4/29/19971i11iJViV I.,VU1V 1 T L�YHK11V1r.1V 1 Vt' ri�HLlri
800 S. Prince St.
•Princeton, Indiana 47670� Q �� _����y,oa
812-385-3831
RECORD OF DEATH
THIS IS TO CERTIFY
that according.to the records of the Gibson County Department of Health,
BSRNICB WALLAC$ ' •
Died on 03/22/1991 at 6:45 P.M.
�Good Samaritan Nursing Home
210 Gibson �.
Oakland City ZN 47660
Age at death . 81 Years
Marital Status: widowed
Sex: F
Color: White
Cause of death: Respiratory Arrest
Pneumonia
� Alzheimers Disease
Signed by: Terry Gehlhausen, DO
Hwy 64 West
Oakland City IN 47660
Place of burial Montgomery Cemetery
or removal:
Oakland City IN 47660
Date of burial: 03/25/1991
Funeral home: Lamb-Basham Memorial Chapel
A
S E A L
226 E. Washington
Oakland City IN 47660
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� Signed by y/ �ryC aa�Gylt,/ir8
Gibson County Heal Commissioner
Oakland City, Indiana 04/29/97
Address Date
Recorded locally in Book No. 12 Page No. 7
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Filed: 04/O1/1991
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