Death Certificate - Kolb, Jacob H_1/8/1985;
� �.
��. �
���
�
RECORD OF DEATH
GIBSON COUNTY DEPARTI�IENT OF HEALTH
PRINCEfON, IIvDIdNA
THIS IS TO CERTIFY", that our records show JACOB H. KOLB
4-18-80 at 7:33PM Gibson General Hospital, Princeton, IN
month day year hoar of death � street, hospital, rural
Age at Death 76 Sex male �lo�ahite rqarital Statuc married
years write whether married or single
Primary cause of death given w38— Arnta rnnaast; vP ra; 1 nra
Signed bl• R.E. Weitzel M.D.
physician or coroner
Princeton, IN
address
Place of burial or removal Decker RR, Patoka. IN
name of cemeterp address
Date of buriat 4-21-80 Kendall Princeton, IN
Ftineral D'uector address
SEAL
Gr���, �.°�,�.v
Gibson County Health Commissioner
Oakland Citv, IN 12-4-89
ad�ess date
Recorded locally in book No. 1� page No. 10 ��ed: 4-23-80
G.° - -