Death Certificate - Hosmer, Myrtle Jane_3/22/1994� • - •
GIBSON COUNTY DEPARTMENT OF ��� T�
800 S. Prince St. 1;.�
Princeton, Indiana 47670 j��
812-3d5-3831
R�R 2 21994
RECOF2D OF DEATH
�� �. ���
AUDITOR
THIS IS TO CERTIFY
that according to the records of the Gibson Coimty Department of Health,
MYRTLE JANE HOSMER
Died on 11/13/1�93 at 7:45 AM
Residence
202 Maple St.
Owensville IN
Age at death : 74 Years Sex: F .
llarital Status: Widowed Color: White -
Cause of death: Respiratory Failure. Metastatic Endometrial Cancer,6 manths
Sigied by: James W. Lee
421 Chestnut St.
Evansville IN
Place of burial Maumee Cemetery
or removal: RR ;f 1
Owensville IN 47665
Date of burial: 11/15/1993
F�neral home: Holders Funeral Home of
Gibson County, Inc.
P.O. Box 518
Owensville IN 47665
S E A L
Signed by ��� ,�/�S'fo{�.., ' ,k1J
Gibson County Health � �mmissioner
Oakland City, Indiana 11/18/93
Address Date
Recorded locally in Book No. 12 Page No. 78 Filed: 11/18/1993