Death Certificate - Ewin, Evelyn Laverne_9/20/2005GIBSON COUNTY i-�fL
12�ai
GIBSON COUNTY DEPARTI�SENT OF HEALTH
800 S. Prince St.
Princeton, Indiana a7670
612-385-3531
RECORD OF DEATH
F. Ol
U001J1
�rais Zs To: csaTii+�r
that aceording to the ieco=ds of the Gibaon County Department of Health,
i
� SVSLYN LAVSRNS SWIN
Died on 07/14/2000 at 4:20A:`=
� 4iiTth RegiOral HOSpi�dl
j � xwy 64 West �
� - 02.kland City IIt 47660
Age atideath � 64 YeaXS 3ez: F
Harital Statu9: Mdrried Colors t�'hit2
Cause IE death= septicemia (4 days), Lefc ICnee ?bscess {2 weeics),
j � Ocarian Cancer (za years ago) with Rad-iaLion,
� EilteriL?5, R�^_Je II DM
i
I
Manaeriof death: Natural -
i
sigaed� by: Terry Gehlhauser., DO
� Hwy 64 Ytest �
� Oaklan3 City ZI� 47060
Place bf burial tdonLgomery Ce:-neteiy
oi removal:
� 01::ldnd Cit}' II'7 47650
�
Date of burial: 07/16/2000
I
puneral homeo Corr:-COl•fin �Ftuierai Hoae, Tnc.
i 323 N. [+l�in Stteet ,
' 083:1and city ix 67660
P.ecorded
i
.::� �� -
_{:.�-�`_4� i
('.ti'' NRF:2Q
�`�t+=: �/ �4Q?:
�9-20-�5 12�13
Signed by
Gibson Councy A=a1Lh Commissio:er
locally in Book No. 13
TO�GIB5011 COU�JTY
eri�ceton Indiana �°�2� `�'
Acdress Date
Page Ne. 122
:31
Filed: 07/19/2000
1