Death Certificate - Jost, Carolyn S_3/1/2006�Il�c�p3��
Opy-00508
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GIBSON �UNTY DEPARTMEN'�JF HEALTH
800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
RECORD OF DEATH
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THIS IS TO CERTIFY
that according to the records of the Gibson County Department of Health,
CAROLYN S. JOST
Died on 04/30/2000 at 10:55 PM
Residence
R.R.# 2 Outer E. Gibson St.
Haubsta3t I*I
Age at death . 58 Years
Marital Status: Married
Sex: F
Color: White
Cause of death: Metastatic Breast Cancer, 5 years.
Signed by: Edward Fox, NI.D.
801 St. Mary's Drive
Evansville ZN 47714
Place of burial Sts. Peter & Paul
or removal:
Haubstadt IN 47639
Date of burial:
Funeral home:
S E A L
OS/04/2000
Wade Funeral Home
119 Vine Street Box 220
Haubstadt IN 47639
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R4AR 0 l 2006
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GIBSON COUNTY AUOITCa�
Signed by
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Gibson County Health Commissioner
Princeton, Indiana OS/08/00
Address Date
Recorded locally in Book No. 13 Page No. 117 Filed: OS/08/2000