Death Certificate - Field, Charles_6/23/2000RECORD OF DEATH •
CJ
GIBSON COU\Tl' DEPART�9E\T OF HEALTH
PRIACETOA. 1AUTAAA
THIS IS TO CERTIF1'. that our records show CHARLES R. FIELD died
July 24. 1995 at 4:15 PM Residence 306 E. Walnut St. Ft. Branch, IN
momh day year hour of death svee�. hospital, rural
�:Age at Death 77 Sec Male Color White \Sarital Statuc Marri ed
year� w�rite w�hether married or �in�le
Primary cause of death given �ca= ConQestive Heart Failure Generalized Arterioslcerotic
Cardiovascular Uiseases, Diabetes Mellitus, Toxic Encephalopathy
Si�nedby Quenton B. Emerson, M.D. 802 E. Oak St. Ft. Branch, Indiana
physician or coroner addres�
Place of burial or remo�al St Peter and Paul Haubstadt, IN
name of cemeterv address
Dateo(burial July 27, 1995 Stodghill Funeral Home, Inc Ft. Branch, Indiana
Funeral Uirecror � nddress
SEAL
�� �. �����i
Signed
Gibson Countr Health Commissioner
Princeton, Indiana June 22, 2000
addre�s dace
Recorded locally in book No 12 Page No iZl Filed: July 31, 1