Death Certificate - Kolb, Mary E_3/3/1983X
RF,CORD OF DEATH
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GIBSON COUNTY DEPARTMENT OF HEALTH
PRINCF.TON, INDIANA
THIS IS TO CERTIFY, that our records show MARY E. KOLB � _____����
10/20/82 at 4:15PM Gib. Gen. Hoso. PrincetoJ_Ind _
month day year hwr of death " street, hospital, rural
: Age at Death g� Seac Fe • Color t'�h •�Marital Statua Married
yPSre write whether married ur sinRl�
Primary cause of death given was
Si�ned b�•—_ Krishna Murth
physician or coroner
MD
Respiratory arrest
I'lace of burial or removal__ Decker
name of cemeteq'
Date of burial• 10/23/82 Kendall
Fwneral Director
SEAL
_ Princeton
address
RR _ Patoka
a�ldrr,cc
_Princeton,
address
Ind.
Znd.
Ind.
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Slgflef� ___ _._
� Gibson Covnty Hralth Commissioner
Oakland Citv Illd.-2L2_i/�.3
�addre.ae dnte
Recordeci locally in book No.— 10 Page No.— 77 F;l�:__ 11/1/82 _------- -- ---