Death Certificate - Mason, Judy_4/3/1996� REC;DRD OF DEATH •
•
G[BSO\' COU\'Tl' DEP.aRTAtE\T OF HEALTH
PRI�CETO\. I\DIA\:�
_THIS :S TO CLP.:IFT, .hat our records
.7IIDY MAS^?i
` March 22, 1996 at 1:47PM RES. 100 W. Williams St. Ft. Branch, IN
. month • davi cear hour of death street. ho; pi�al. rural
Age at Death 56 Sex Female Color �ite �farital Status �arried
_ cears ��'rite u'hether married or single
Primary� cause of death given
SMALL CELL LU\G CA\'CER
Signed by Ricky J. Ballou, P1.D. Evansville, IN
� physician or comner address
Place of burial or removal Blythe Chapel Cemetery Owensville, IN
name of cemeten' address
Date of burial March 26 1996 StodQhill Funeral Home, Inc. Ft. Branch, Itv'
Funeral nirecror address
SEAL
Signed ��/ �`� • �����
Gibson Countr Health Co . issioner
Oakland City, IN April 3, 1996
address
Recorded locally in book No. 13 Page \o. 8 Filed April 3 1996
date