Death Certificate - Guller, Jewel Nicholas_4/13/1993�
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RECORD OF DEATA
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APR 1 s 1993
�UDITOR�s
GIBSO\ COUDITY DEPARTivtENT OF HEALTH
PRI\CETOt, I�DIA�A
THIS IS TO CER'I'IFY, that our records show JESdEL VICHOLAS GULLER died
n�r�t,Pr �7 7991 ac 10:55 A.M. Gibson General Hospital Princeton, Indiana
mon[h day year hour of dea[h street, hospital, rural
Age at Deach 74 Sex Male Color �ite �ari[al Stzcus Married
Ye� write whe�her married or single
Primary cause of death given was acnte Anterior Wall Infarction 10/23/91
n riat F'b �ttacion 11/90. Coneestive Heart Failure 5/13/91 Aortic Aneurysm 11/40
Signedby HaGSan Rayes. M.D. 1814 Sherman Dr. Princeton, Indiana
physician ar coroner � address
Place of burial or
name of cemetery
Owensville, Zndiana
address
Dateofburial October 30. 1991 Holders Funeral Home of Gibson County Inc. Owensville In.
Funeral Director address
SE.�L
Signed ���, `y�y.�/., aCCa�r%y�
Gibson County Health Co ` issianer
Oakland Citv. Indiana November 7 1991
address da[e
Recorded locally in book No. 12 Page Vo.23 Filed: vovember 1, 1991