Death Certificate - Deal, Darby Ollie_12/7/2000GIBSOIV�OUNTY DEPARTIVIEI� GF HEALTH '
800 S. Prince St.
Princeton, Zndiana 47670
812-385-3831
RECORD OF DEATH
THIS ZS TO CERTZFY
that according to the records of the Gibson County Department of Health,
DARBY OLLIE DF!AT,
Died on 11/14/2000 at 11:OSAM
Residence
R.R.n 3 Box 274
Owensville IN
Age at death . 87 Years
Marital Status: Married
Sex: M
Color: White
Cause of death: Acute Exacerbation of Chronic Renal Failure, Weeks
Congestive Aeart Failure, Years
Polycystic Kidney Disease, Years
Previous CVA
Signed by: Lance Payton, M.D.
410 North Main St
Princeton IN
Place of burial Owensville Cemetery
or removal:
Date of burial:
Funeral home
S E A L
Owensville IN 47665
11/17/2000
Holders Funeral Home of
Gibson County, Inc.
P.O. Box 518
Owensville IN 47665
Signed by � G. °%''``"_""' '��(�
Gibson County Health Comm ssioner
Princeton Indiana 11/21/00
Address Date
Recorded locally in Book No. 13 Page No. 132 Filed: 11/21/2000