Death Certificate - Chappell, James Harold_5/3/2000GIBSON�UNTY DEPARTMEN'�F HEALTH
800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
RECORD OF DEATH
THIS IS TO CERTIFY
that according to the records of the Gibson County Department of Health,
JAMES HAROLD CHAPPELL
Died on 04/27/2000 at 12:55am
Gibson General Hospital
1808 Sherman Drive
Princeton IN 47670
Age at death : 102 Years Sex: M
Marital Status: Widow Color: white
Cause of death: Cardio Respiratory Failure,
Pneumonia, CHF
Signed by: Narnyan Ghanta, M.D.
P.O. Box 137
Ft. Branch IN 47648
Place of burial Montgomery Cemetery
or removal:
Date of burial:
Funeral home:
S E A L
Oakland City IN 47660
OS/O1/2000
Corn-Colvin Funeral Home, Inc.
323 N. Main Street
Oakland City IN 47660
Signed by e�.LLG�t��'. .I.'��i� i�ii
Gibson County ealt�is�;:Cdiritd� ssioner
Recorded locally in Book No. 13
Princeton, Indiana OS/03/00
Address Date
Page No. 117 Filed: OS/03/2000
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