Death Certificate - Lutz, Mildred Jean_11/5/2003�� . �
GIBSON COUNTY DEPARTMENT OF HEALTH
800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
RECORD OF DEATH
THIS IS TO CERTIFY
that according to the records of the Gibson County Department of Health,
MILDRED JEAN LIITZ
Lied on G'./1=/2003 at 3:30am
Residence
RR = 1, Box 278
Princeton ZN 47670
Age at death . 77 Years
Marital Status: Married
Sex: F
Color: White
Cause of death: Adeno Carcinoma Right Co1on (18 months) with Liver
Metastasis, Mitral Insu£ficiency,
Hypertension
Signed by: William R. Wells, MD
510 N.Mair. St.
Princeton IN 47670
Place of burial Evansville Crematory
or removal: .
Evansville IN
Date of burial: 03/18/2003
Funeral home: Colvin Funeral Home, Inc.
S E A L
425 N. Main St.
Frinceton IN 47070
� � y ::--: -,�
� .,-;
�' :._/
N 0 V u y 2003
:i
(� �
� '�'-�`!f�✓ �2-� =. �-�-�
GI3SGN COU�:7Y i,UDIiOR !
.,��.� G. j�.��i%�i
Signed by
Gibson County Y.ealth Com-nissioner
Princeton, Zndia.^.a 03/18/03
Address Date
Recorded locally in Book_ uo. 1a Page No. 59
Filed: 03/18/2003
r
i i .