Death Certificate - Farmer, Lisa Ann_1/7/2003r � GIBSOl��OUNTY DEPARTMENT O�ALTH
_ 800 S. Prince St.
• Princeton, Indiana 47670
• 812-385-3831
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RECORD OF DEATH �
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THIS IS TO�CBRTIFY
that according to the recorda of the Gibson County Department of Health,
• LISA ANN FARMSR
Died on 08/10/2002 at 4:39AM
Gibson General Hospital
1808 Sherman Drive
Princeton IN 47670
Age at death . 36 Years
Marital Status: Married
Sex: F
Color: white
Cauae of death: Multiple Medication Toxicity
Signed by: David M. Corn, Chief Dep. Coroner
425 N. Main
Princeton IN 47670
Place of burial Maumee Cemetery
or removal: RR # 1
OwenSVille IN 47665
Date of burial: OS/14/2002
Fuaeral home,c�^ Holders FYuieral Home of
^' -`•'� �pGibson County, Inc.
1�� - � P�:O. Box 518
�' -` O.i�:nsville IN 47665
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JAN 7 2003
' � GIB�ti�DITOR I
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=. L _ Signed by
; - - - Gibson County Health Commissioner
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-'�,,�-.-- !• Princeton, Indiana 09/04/02
� --' Address Date
Recorded locally in Book No. 14 Page No. 45 Filed: 09/04/2002