Death Certificate - Johnson, Elmer W_1/23/2007�._ _ �_.,..`E;.., i..ii'E:14�_`;�J�,:il`4 t� e�ie I.i11u: �-�. �
� !r 1�• li;sti�� ��Tt"� � t•� �'-'^�'"�*1�1i'P'i
GIB�' COUNTY DEPARTMENT �HEALTH
800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
RECORD OF D�ATH
TAIS IS TO CERTIFy
that according to the records of the Gibson County Departmeat of Health,
ELMER W, JOHNSON
Died on 12/27/1991 at 11:44am
Gibson General Hospital
1808 Sherman Drive
Princeton IN 47670
Age at death . 73 Years
Marital Status: Married
Sex: N
Color: White
Cause of death: Acute Ventricular Fibrillation (sudden),
Mitral Valve Disease & ASHF with CHF (long standing),
Previous Mitral Valve Surgery & C.A.B.
Signed by: William R. Wells, Nm
510 N.Main St.
Princeton IN 47670
Place of burial St. Joseph Cemetery
or removal:
Princeton Iiv* 47670
Date of burial: 12/30/1991
Funeral home: Colvin F'uneral Home, Inc.
:25 N. Main St.
PrinCetOR IN 47670
Sigaed by _ °"'^""`.". �. �/,���i� /VY�
Gibson County Health Commissioner
S E A L
Recorded locally in Book No. 12
Princeton, Indiana O1/11/07
Address Date
137555
Page No. 28 Filed: Ol/02/1992
NRA-2p
(7/O5) f