Death Certificate - Barrett, Charles Richard_3/18/2003GIBSON COUNTY DEPARTMENT OF HEA�TH
2�800 S. Prince St.
ceton, Indiana 47670
812-385-3831
RECORD OF DEATH
THIS IS TO CSRTIPY
that according to the recorde of the 6ibaon County Department of 8ealth,
CHARL$S RICHARD BARRSTT
Died on 12/19/2002 at 11:14AM ��
Gibson General Hospital
1808 Sherman Drive
Princeton IN 47670
Age at death . 72 Years
Marital Status: Married
Sex: M
Color: White
Cause of death: Cardiac Arrest, minutes. Acute Respiratory Failure,24 Hours
Advance Chronic Obstructive Pumonar.Diaease,Years.
AthCLOSClELOt1C HEdit D162dSE8� D13bEtB8.
Signed by: Rameshbhai P. Patel, hID
105 N. 2nd Ave.
Princeton IN 47670
Place of burial Memorial Park
or rr�oval:
EYansville IN
Date of burial: 12/23/2002
Punezal home:
S $ A L
Ziemer Ftuieral Home, Central
625 First Ave.
Ev��sville IN 47710
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� Signed by " ` G �/��/" �
Gibson County Health Commisaioner
Recorded locally in Book No. 14
Princeton, Indiana 12/20/02
Addresa , Date
Page No. 53 Filed: 12/20/2002
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