Death Certificate - Elderbrook, Clarence_8/21/1991G I B S O N
• • ���u�
COUNTY DEPAF2TMENT OF HEALTH
800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
R E C O R D O F D E A T H
THIS IS 1'0 CHFifIFY
that according to the records of the Gibson Coimty Department of Health,
- CLARENCE ELDSRBROOK
Died on 07/31/1991 at 5:04 A.M.
Residence
' R.R.7i2 Box 311
Haubstadt IN 47539
Age at death: 59 Sex: M Color: White
•Cause of death: Lung Cancer, months
Si�ed by: Thomas Browne, I�ID
611 Harriet St.
Evansville IN 47710
Place of burial Poseyville
or removal:
Poseyville IN 47633
Date of burial: OB/02/1991
F�neral home: Werry Funeral Home
S E A L
Poseyville IN 47633
6
Marital Status: Married
Signed by v1/ ��'ifG. ����
Gibson County Healt ommissioner
Recorded locally in Book No. 12
Oakland City, Indiana 08/07/91
Address Date
Page No. 16 Filed: 08/07/1991