Death Certificate - Whitehead, Ottis_8/15/1985RECORD OF DEA1`H •
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GIBSON COUNfiY DEPARTMENT OF HEALTH
PRINCETON,INDIANA
THIS IS TO CERTIFY, that our records
4/7/81 at 7:10AM Wirth
month day year hour of death
OTTIS WHITEHEAD
Oakland City, Ind.
street, hospital, raral
Age at Death �$ gex Tiale Color j�lt�'farital Status Married
years write whether married or �ngle
Primary cause of death given was pneumonia
Black Lunq (pneumonoconiosis) Pos. CA L. Luna
Signed by H. A. Peters, D.O. Oakland Citv, Ind.
physician or coroner address
P1ace of burial or
Date of buria�
SEAL�
Maple Grove
name of cemetery
4/9/31 Lamb-Hedges
F�neral D'uector
Boonville, Ind.
address
Oakland City, Ind.
addrnss
"v - i / �Zl � � r /t1�%
Sign
Gibson Coanty Health mmissioner
•-. .�• .•
Recorded locally in book I�To. 1 � page No. 3 8F;1� ; 4 Y 2 2/ 81