Death Certificate - Green, Denver L Sr_5/13/2004G�N COUNTY DEPARTME�F HEALTH
800 S . � Prince St .
Princeton, Zndiana 47670
812-385-3831
RECORD OF DEATH
THIS IS TO CERTIPY
that accordiag to the records of the Gibson County Department of Health,
DENVER L. GRBEN, SR.
Died on 03/14/2000 at 5:25 PM
Good Samaritan Nursing Home
210 Gibson
Oakland City IN 47660
Age at death . 69 Years
Marital Status: Married
Sex: M
Color: White
Cause of death: Sepsis, 3 days
CHF, Dementia, Multiple Decubiti
Manner of death: Natural
Sigaed by: Terry Gehlhausen, DO
Hwy 64 West
Oakland City IN 47660
Place of burial Somerville Cemetery
or removal:
Somerville IN 47683
Date of burial: 03/17/2000
Funeral home: Lamb-Basham Memorial Chapel
S E A L
226 E. Washington
Oakland City IN 47660
Signed by � G �/�/ �
Gibson County Health Commissioner
Princeton, Zndiana OS/12/04
Address Date
1 •
...�
Recorded locally in Book No. 13 Page No. 114 Filed: 03/20/2000
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