Death Certificate - Busch, John_10/9/2012THIS IS AN OFFICIALTiCOP.Y�OF RECORDiOF]DEATHTORIGINANCOP.Y/ONjF,ILE�AT�IN01ANAiSTATEIDEPARTMENTIOF�HEALTH�
GIBSON COUNTY DEPARTMENT OF HEALTH
800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
RECORD OF DEATH
THIS IS TO CERTIPY
that according to the recorda of the Gibson County Department of Health,
JOHN H. BIISCH
Died on OS/16/2009 at 4:OOPM
Residence
8239 S 100 W
Ft. Branch IN 47648
Age at death . 65 Years
MdI'1td1 3tatue: Married
Sex: M
Color: White
Cause of death: Atherosclerotic Cariovascular Disease.
Manner of death: Natural
Signed by: David A.Knowles, Cheif Deputy Coroner
425 N. Main St.
Princeton IN 47670
Place of burial Southwestern Indiana Regional
or removal: Crematory
Dale IN
Date of burial:
Funeral home:
S E A L
Stodghill Funeral Home, INC
304 W. Locust Street
Ft. Branch IN 47648
Signed by /��/1-« � ��Jr RQ
Gibson County Health Commissioner
Princeton, Zndiana 10/09/12
Address Date
i � • � � �
Recorded locally in Book No. 5/2008 Page No. Filed: OS/20/2008
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