Death Certificate - Colvin, Jack G_10/14/1992�.
G I B.S O N
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C O U N T Y D E P A R T M E N T
800 S. Prince St.
Princeton, Indi°ana 47670
812-385-3831
R E C O R D O F D E A TH
O F H E A L T H
1'HIS IS 1'0 CEEtTIFY
that according to the records of the Gibson County Department of flealth,
JACK G. COLVIN
Ilied on 09/02/1991 at 3:30am
- 522 N. West
Princeton IN 47670
Age at death: 80 Sex: M Color: White Marital Status: Married
Cause of death: Myocardial Infarction, Cardiomyopathy Ischemic,
Congestive Heart Failure.
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Signed by: Arun C. Kumar, MD
105 N. 2nd Ave.
Princeton IN 47670
Place of burial Maple Hill ,,,,
or removal:
Princeton IN 47670 ,,,,
Date of burial: 09/04/1991 ' � -
Fimeral home: Colvin Funeral Home, Inc.
425 U. Main St.
Princeton IN 47670
S E A L
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Signed by � �^�.
Gibson County Health Commissioner
Oakland City, Indiana 09/06/91
Address Date
Recorded locally in Book No. 12 Page No. 18 Filed: 09/06/1991
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