Death Certificate - Lewis, Russell_4/19/1999' �,TR:�nN-�I�NTY r.IF,PA.RTMF..NT � HF..AT_,TN
Oi�',���.� dUU S. Prince S�.
, __ .� _
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,
:!
�1 Died on O1/28/1999 at 10:51PM
,( `l',• Gibson General Hospital
1808 Sherman Drive
Princeton ZN 47670
Age at death . 74 Years
Marital Status: Married
Sex: M
Color: White
Cause of death: Ischemic Cardiomyopathy, Severe COPD,
ABD Aortic Aneurysm
Signed by: Arun C. Kumar, MD
105 N. 2nd Ave.
Princeton IN 47670
Place of burial Walnut Hi11 Cemetery
or removal:
Ft. Branch IN 47648
Date of burial: 02/O1/1999
Funeral home: Stodghill Funeral Home, INC
S E A L
304 W. Locust Street
Ft. Branch IN 47648
Signed by �G�✓/4�+'•'•r�a°'-�.�T1
Gibson County He h Commissioner
Oakland City, Indiana 02/04/99
Address Date
Recorded locally in Book No. 13 Page No. 83 Filed: 02/04/1999