Death Certificate - Gray, Herbert M_4/21/1998e
GIBSON CO�iTY DEpARTMENT �HEALTH
800 S.. Prince St.
Princeton, Indiana 47670
812-385-3831
RECORD OF DEATH
THIS IS TO CERTIFY
that according to the records of the Gibson Couaty Department of Health,
HSRBSRT M. GRAY
Died on 04/11/1998 at 6:42AM
Good Samar'itan Nursing Home
210 Gibson
.' Oakland City.ZN 47660
Age at death .
Marital Status:
78 Years
Married
Sex: M
Color: white
Cause of death: Acute Cardiac Arrest, Minutes
CHF, Years. Dementia.
Signed by: Terry Gehlhausen, DO
Hwy 64 West
Oakland City IN 47660
Place of burial Oak Hill Cemetery.
or removal:
Date of burial:
Funeral home:
S E A L
Patoka ZN 47666
04/15/1998
Colvin Funeral Home, Inc.
425 N. Main St.
Princeton IN 47670
Signed by ��K�/�'lyG�. �'��
Cibson Cou�ty Healt /Commissioner
Oakland City, Indiana 04/21/98
Address Date
Recorded locally in Book No. 13 Page No. 64 Filed: 04/20/1998