Death Certificate - Mason, Henery_1/20/1995GIBS�COUNTY DEPARTMENT � 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,
HENRY ROY MASON
Died on 08/20/1992 at 9:40 AM
Residence
1007 South Main St.
Princeton IN 47670
Age at death . 75 Years Sex: M
Marital Status: Married Color: White
Cause of death: Metastatic Prostate Cancer
Signed by: Chester Burkett, M.D.
P.O. Box 550
Poseyville IN 47633
Place of burial Columbia Church Cemetery
or removal:
Princeton IN 47670
Date of burial: OS/22/1992
Funeral home: Colvin Funeral Home, Inc.
S E A L
425 N. Main St.
Princeton IN 47670
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Signed by �'f' �' G' �
Gibson County Healt Commissioner
Oakland City, Indiana O1/20/95
Address Date
Recorded locally in Book No. 12 Page No. 45 Filed: 08/26/1992