Death Certificate - Hartley, Larry Don_10/16/1995, . GIBS�OUNTY DEPARTMENT �HEALTH
800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
RECORD OFDEATH
THIS IS TO CERTZFY
that according to the records of the Gibson County Department of Health,
LARRY DON HARTLEY
�ied on u8/24/i594 at 'r.M.
Residence
307 East Vine St.
Patoka IN
Age at death . 57 Years
Marital Status: Divorced
Sex: M
Color: white
Cause of death: Cardio Respiratory arrest, Immediate
Ventricular Fibrillation, Immediate.
CVHD, 10 years.
Signed by: Bruce C.. Brink, Sr., DO
410 N. Main
Princeton IN 47670
Place of burial Decker Cemetery
or ramoval:
Patoka, IN 47666
Date of burial: 08/27/1994
Funeral home: Colvin Funeral Home, Inc.
6��ei�l
425 N. Main St.
Princeton ZN 47670
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Signed by ✓'✓ � _ � -�'• .r�'
Gibson County Healthi-Commissioner
Oakland City, Indiana OS/30/94
Address Date
Recorded locally in Book No. 12 Page No. 97 Filed: 08/30/Z994