Death Certificate - Kelley, Dora Ethel_4/16/2010GIBSON COUNTY DEPARTMENT OF HEALTH
800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
RECORD OF DEATH
THIS ZS TO CERTIFY
that according to the records of the Gibson County Department of Health,
DORA ETHEL KELLEY
Died on 10/21/2000 at 1:40am
ResidenCe
RR # 3, Box 85
Owensville IN 47665
Aae at death . 57 Years
Marital Status: Married
Sex: F
Color: White
Cause of death: Glioblastoma Multiforme, Progressive (8 months)
Glioblastoma Multifornie (1 year)
Signed by: Daniel Shirey, M.D.
611 Harriett St. Suite L100
Evansville IN 47710
Place of burial Owensville Cemetery
or removal:
Date oP burial:
Funeral home:
S E A L
Owensville IN 47665
10/24/2000
Holders Funeral Home of
Gibson County, Inc.
P.O. Box 518
Owensville IN 47665
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Signed by
Gibson County Health Commissioner
Princeton, Indiana 10/27/00
Address Date
Recorded locally in Book No. 13 Page No. 129 Filed: 10/27/2000