Death Certificate - Adams, Mabel C_2/24/1995G1ES�;, i3OUN-`Y fl��:1�iM�NT OE ri[�LTi-i
�a�C S. ?rir.ce St.
Pr���cetor., Z.^.diar.a 476•
`3�2-385-3831
RcCORD OF DE.4TN
.''
THIS IS TO CERTIF':
tnat according to t^e reco-ds of the Gibson County Department of Health,
2dr13SL C. ADAb1S
Died ca OS/24/199Y a= 4:30 9.?�!.
� Forest Del Co.^.valescent Center
1020 Vine S�ree�
?rince�o� :N �7670
Age at death . 77 `!ears Se:c: F
Marital Status: W:dowec Color: W!:ite
Cause o£ death: Be�zl Failure, P.SCVD
Sigaed by:
Place of burial
or removal:
Edr:ard 47hi�e, D.O.
410 Nor�h Main St.
Prl:?CELOP. Ti`I
Z.C.O.F. Cemeter�
10'_5 N. Ea�c S�.
PLiIICeto❑ IN 476iQ
Date of burial: 09/26/199Y
Funeral home:
S E A L
Colvi� ru�eral iiome, ?nc.
425 i7. afai.^. St.
?r� :ce�or. iv �7G70
/� .o f/
Signed bv ��1i�1`�",,.�/, .��,�.r4�k
Gibson Countv Y:ealti:^'. Co;nmissione=
Oaklar.c Citv, India.^.a OS/30/94
:�dd_ess Da�e
Recorded iocally in Joo'K No. 12 ?age No. 97 ri�ed: 08/30/199;