Death Certificate - Dockery, Velma B_1/27/2012GIBSON COUNTY DEPARTMENT OF HEALTH
800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
RECORD OF DEATH
THIS IS TO CSRTIFY
that according to the records of the Gibson County Department of Health,
V$LMA B . DOCICSRY
Died on 08/22/2009 at S:SOPM
River Oaks xealth Campus
Princeton IN �
Age at death . 94 Years Sex: F
Marital Status: Widowed Color: Color
Cause of death: Pneumonia
Hypertension and CHF
CA Colon
CA Breast
Manner of death: Natural
Signed by: Bruce C. Brink, Jr., D.O.
410 N.Main
Princeton IN 47670
Place of burial Forrest Township Cemetery
or removal:
Forrest IL
Date of burial:
Funeral home: Colvin Funeral Home, Inc.
425 N. Main St.
Princeton IN 47670
S E A L
S igned by /�J�(/s-��G � /J �%r � Q
Gibson County Health Commissioner
Princeton, Indiana O1/26/12
Address Date
�35747
Recorded locally in Book No. 8/2009 Page No. Filed: 08/27/2009
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