Death Certificate - Lacy, Ralph_10/7/1991i
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G I B S O N
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COUNTY DEPAI2TMENT-
800 S. Prince St.
Princeton, Indiana 47670
812-385=3831
RECORD OF.,� DEATH
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O F H E A L T H
THIS IS 1'0 CERTIFY
that according to the records of the Gibson County Department of Health,
RALPH LACY
Died on 09/20/1991 at 7:33 P:M. "'
_ Gibson General Hosp'ifal
1808 Sherman Drive :'` .
Princeton IN 47670
Age at death: 82 Sex: M Color: White Marital Status: Married
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Cause of death: Acute Myocardial Infarction 36 hours
Coronary Arteriosclerosis, Coronary Thrombosis 1 week
Gastric Ulcer, Chronic Bronchitis, Coal Workers'
Renal Insufficiency, Pneumoconiosis.
Signed by: Krishna Murthy,MD
105 N.2nd
Princeton IN 47670
Place of burial Maple Hill
or.removal:
Princeton IN 47670
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OCT 7 1991
Date of burial: 09/24/1991, •
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Funeral home: Colvin Funeral Home, ia�.' � AUDITOR
425 N. Main St.
Princeton IN 47670
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Signed by __ -..�,'1��%`-z^'�P �'°�� ��
Gibson County Health(,Commissioner
- S E A I :
Oakland City, Indiana 09/30/91
Address Date
Recorded locally in Book No. 12 Page No. 20 Filed: 09/30/1991