Death Certificate - Burger, Melvin John_8/6/2002_ ,..
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GIBSON,COUNTY DEPARTMENT OF HEALTH
800 S. Prince St.
Princeton, indiana 47670
812-385-3831
� � RECORD OF DEATH
THIS IS TO CSRTIFY
that according to the records of the �ibeon County Department of Health,
MBLVIN JOHN SIIRGBR
Died on 06/17/2002 at 10:42am
Residence
507 E. Sinclair Street
� Ft. Branch ZN 47648
Age at death . 69 Years
Marital 6tatus: Married
Sex: M
Color: White
Cauae of death: Small Cell Lung Cancer (10 months)
Signed by: Anthony Stephens,hID
801 St. Mary�s,Dr.
EvdnSVille IN 47714
Place of burial Holy Cross
or removal:
- Ft. Branch IN 47648
Date of burial: 06/20/2002
Puaeral home: Stodghill Funeral Home, INC
S E A L
304 W. Locust Street
Ft. Branch IN 47648
Signed by _ � G ������
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Gibson County Health Co issioner
Princeton Zndiana 06/26/02
Address Date
Recorded locally in Book No. 14 Page No. 41 Filed: 06/26/2002