Death Certificate - Blaize, Richard C_4/21/2003� •
GIBSON 'COUNTY DEPARTMENT OF HEALTH
800 3. Prince St.
Princeton, Indiana 47670
812-385-3831
RE C O RD O F D E A TH
?
THIS IS TO CHRTIFY
that according to the records of the Gibson Coimty Depnrt�ent of Health,
RICHARD C. BLAIZfi
Died m O1/2Q�1994 at 11�:49PM
Gibson General Hospitel
1808 Shec�an Drive
Princeton IN 47670
Age at death : 55 Years Sez: M
Meritel Stntus: Married Color: Nhite
Cause of deet6: Acute Myocardiai Infarction (5 minutes)
3igaed by: Scott Stodghill, Coroner
304 M. Locust St.
Ft. Brench IN 47648
Place of burial I.O.O.F.
or r�oval:
Francisco IN 47649
llate of burial: O1/25/1994
i'�meral Loue: Colvin £uneral Home, Inc.
425 N. Main St.
Princeton IN 47670
S E A L
Signed by
Gr���-�,�� .�':_.
Gibsoa County Health Co�issioner
Oaklend Citv, Indiana O1/27/94
Address Date
Recorded locally in Book No. 12 Page No. 84 Filed: O1/27/1994