Death Certificate - Capehart, Randall_1/18/2001GIBSON (�IUNTY D�PARTMEN'I�F HEALTH
800 S. Prince St.
Princeton, Indiana 47670
Q( R' p�o 7�/-� 812-385-3831
V J V
RECORD OF DEATH
THIS IS TO CERTIFY
that according to the records of the Gibson County Department of Health,
RANDALL "BIID" CAPEHART
Died on O1/12/2001 at 12:OOPM
Residence
522 W. Oak st.
Princeton IN 47670
Age at death .
Marital Status:
Cause of death:
Signed by
Place of burial
or removal:
Date of burial:
Funeral home:
S E A L
76 Years
Married
Sex: M
Color: White
Extensive Small Cell Lung Cancer, 6 weeks.
Hypertension, Atherosclerotic Heart Disease.
Rameshbhai P. Patel, MD
105 N. 2nd Ave.
Princeton IN 47670
Nlaple Hill
Princeton IN 47670
O1/16/2001
Colvin Funeral Home, Inc.
425 N. Main St.
Princeton IN 47670
Signed by � G i���+��
Gi son County Health Commissioner
Princeton, Indiana O1/16/O1
A dress Date
Recorded locally in Book No. 14 Page No. 1 Filed: O1/16/2001