Death Certificate - Herod, Florence_1/31/1991RECORD OF DEATH #
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GIBSON COUNTY DEPARTMENT OF HEALTH
PRINCETON, INDIANA
THIS IS TO CERTIFY, thet our records show ��� �OD died
Janurary 23. 1991 at 9:SOPM Forest Del Convalescent Center. Princeton IN
month dey year hour of deeth nveet, hoapital, rurei
Age at Death 91 Sex Female �o�or white Meritsl StsWa Widow
yeara write whether memed w ningle
Primery ceuse of death given was Septicemia. Myelodysy,lasia. Pancytopenia
Signedby Ynng ('hn M.il_ Prinretnn_ IN
physicien or coroner eddreee
Place of burial or removal Maple Hill Cemetery Princeton, IN
name of cemetery eddreea
Dateofburial 1/2R/t991 Colvin Funeral Home Inc. Princeton. IR
� Funerel D'vecwr eddreet
SEAL
Signed � K�►'1f li�. �OUa2+%f%f.T�
Gibaon County Health Com aioner
Oakland City, IN January 29, 1991
eddrees date
Recorded locally in book No lZ Page No. 3 Filed: January 29, 1991