Death Certificate - Lutz, Naomi M_12/23/1991- - --... _. � �
RECORD OF DEATH
GIBSON COUNTY DEPARTn1ENT OF HEALTH
PRINCETON, RJDIANA
THIS IS TO CERTIFY, thet our records show NAOMI M. LUTZ died
Aoril 21, 1991 at 1:25 A.M. Gibson General Hospital Princeton. Indiana
month day yeer hour of death street, hospital, rural
Age at Death 86 Sex Female Color White n9arital StaWs Married
yeere � write whether married or single
Primary cause oE death given wa� Hepato-Renal Failure , Arteriosclerotic Cardiovascular Disease.
Signedby Yonrt Cho, ML Gibson General Medical Offices Princeton, Indiana
physician or coroner address
Place of burial or removel Sts. Peter and Paul Haitbstadt, Indiana
neme of cemetery address
Date of burial April 24, 1991 StodRhill Funeral Home Ft. Branch, Indiana
Funersl Director eddress
SEAL
Signed -/i�����9G�. "`�C./y,=7
Gibson County Heelth Com sioner
Oakland Citv, Indiana April 30, 1991
eddress date
Recorded locally in book No. 12 Page No. 10 Filed: APril 30, 1991