Death Certificate - Price, Charles Berwayne_5/2/2003GIBSCliG COUNTY DEPARTMENT O�HI?ALTI-I
800 S. Prince St. •
Princeton, Indiana 47670
812-385-3831
RECORD OF DEATH
TAIS IS TO CHRTIFY
that according to the records of the Gibsoa County Department of aealth,
CHARLES BERWAYNE PRICE
Died oa OS/20/2002 at 6:OOpm
Residence
510 N. POlk St.
Oakland city IN 47660
Age at death . 84 Years
Marital Status: Married
Cauae of death: Pneumonia
9ex: M
Color: White
Signed by: Paul V. Banning, M.D.
welborn Clinic
Princeton IN 47670
Place of burial Montgomery Cemetery
or removal:
Oakland City ZN 47660
Date of buzial: OS/25/2002
Funeral home: Corn-COlvin Funeral Home, Inc.
S E A L
323 N. Main Street
Oakland City IN 47660
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Signed by
Gibson County Health Commissioner
Princeton, Indiana OS/28/02
Address Date
Recorded locally in Book No. 14 . Page No. 39 Filed: OS/24/2002
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