Death Certificate - Rhinefort, Adrian_10/7/2003GIBS� COUNTY DEPARTMENT (�iEALTH
800 S. Prince St.
Princeton, Zndiana 47670
812-385-3831
RECORD OF DEATH
THIS IS TO CERTIPY
that according to the records of the Gibson Couaty Departmeat of Health,
ADRIAN W. RHINEFORT
Died oa 04/03/2002 at 7:20PM
Residence
R.R.2 Box 5 -
Ft. Branch IN
Age at death . 80 Years Sex: M
Marital Status: Married Color: White
Cause of death: Myocardial Znfarction, Coronary Arte-y Diseaese.
Signed by: Larry Lutz, M.D. �
802 E Oak St.
Ft. Branch IN
Place of burial St. Lucas
or removal:
Ft. Branch IN 47648
Date of burial: 04/06/2002
Funeral home: Stodghill F�neral Home
304 W. Locust Street
__ Ft. Sranch IN 47648
Signed by �
CJ�'�- G /�?�.f+��'�/
Gibson Cour.ty Health Commissioner
S E A L
Princeton, Indiana il/07/02
Address Date
Recorded locally in Book No. 14 Page No. 36 Fi1ec: 0�/OS/2002