Death Certificate - Lee, Samuel J_10/10/1989�`, :.� -
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RECORD OF DEATH
GIBSON COUNTY DEPARTI•iENT OF HEALTH
PRINCETO\. INDIANA
i THIS IS TO CERTIFY, that our records sho�e SAMUEL J. LEE d�e�
I March 30, 1986 a� 6:55 A.M. 321 N. Hall St. Princeton, In.
� month dey year hour of death street, hospital, rurel -
�
j Age et Death 69 Sex Male Color White 1larital Status ^larried
years write wheiher maxried o: sin�le �
� Primary cause of death given was Acute Plvocardial Infarction Arteriosclerotic Vascular
n;GaasP,�vPr�grobable Arrhythmia, Pulmonarv Conqestion and Edema. F;
Signedby R;�hard D. Hickrod Coroner Princeton, In. ��
physician or coroner eddress ��
Placeofburialorremoval Wh;ta C'hnr�h Princeton. In. �'
. name of cemecery eddress j��
Dateofburial Hpril 2'; 1986 Colvin Funeral Home, Inc. Princeton, In. `
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� Funeral Direc[or address :�.
�y�r��
Signed �f!�l/"���'�A_�i�, ����
- Gibson County Health Comrq3� ione�
Oakland City, In. �larch 30, 1987
eddress � � da[e
Rewrded locally in book No. 1 1 Page \'o. 7 Filed: April 1, 1986