Death Certificate - Kruse, Harold L_3/4/2003GIBS� COUNTY DEPARTMENT� (-IEALTH
800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
RECORD OF DEATH
THZS IS TO CERTIFY
that according to the records of the Gibaon County Departmeat of Health,
HAROLD L. RRIISE
Died on 02/21/2003 at 5:40 PM
owensville Convalescent Center
Hwy 165
Owensville IN 47665
Age at death . 86 Years
Marital Status: Married
Sex: M
Color: White
Cause of death: Pneumonia,
Congestive Heart Failure, HTN, COPD
Signed by: Quentin B. Emerson, hID
802 E. Oak St. P.O. Box 185
Ft. Branch IN 47648
Place of burial St. Lucas
or removal:
Ft. Branch IN 47648
Date of burial: 02/25/2003
Funeral home: Stodghill Ftuieral Home, INC
S E A L
304 W. Locust Street
Ft. BranCh IN 47649
Signed by ^�'�"" G' i��//, rvy�
Gibson County Health Commissioner
Princeton, Indiana 02/28/03
AddT055 Ddte
Recorded locally in Book No. 14 Page No. 58 Filed: 02/28/2003