HomeMy WebLinkAboutDeath Certificate - Peek, David Lee_8/27/1997GIBSON C�.TNT oDEPA RTMENT �F HEALTH
, Princeton, Indiana 47670
812-385-3831
RECORD OF DEATH
THIS IS TO C$RTIFY �f Health,
that according to the recorde of the Gibson County De �
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DAVID LEB PESK
AUG 2 7 1991
Died on 08/13/1996 at 10:27PM
Residence
RR # 2, Aarvey Cut Thru Ro
Princeton IN 47670 �BSON OU 7�
ALiOiTOR
Age at death . 53 Years
Marital Status: Married
Sex: M
Color: White
Cause of death: Adenocarcinoma of Unknown Primary (1 year),
Hepatic Failure 2nd Degree Metastasis (1 month)
Signed by: James Lee, M.D.
421 Chestnut
Evansville IN
Place of burial Columbia White Church Cemetery
or removal:
Princeton IN 47670
Date of burial:
Funeral home:
S E A L
08/17/1996
Colvin Funeral Home, Inc.
425 N. Main St.
Princeton IN 47670
Signed by
�F1 L��1 �r• tb � /5ri'i'
Gibson County Hea h Commissioner
Oakland City Indiana 07/31/97
Address Date
Recorded locally in Book No. 13 Page No. 18 Filed: 08/20/1996