Death Certificate - Rose, Douglas E_5/14/1999.
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� l.iliiJt'Jl�i l.l.�1V i Y 1lli,P 'r`il<11V1�1V 1 �� r1bAi, i�-i
800 S. Prince St.
' � Princeton, Indiana 47670
812-385-3831
RECORD OF DEATH
THIS IS TO CERTIFY
that acco=ding to the records of the Gibson County Department of Health,
DOUGLAS E. ROSE
Died on 12/25/1998 at S:15AM
Residence
� RR # 2 Box 220A Meadowlark Dr.
Princeton IN 47670
Age at death .
Marital Status:
69 Years
Married
Sex: M
Color: White
Cause of death: Bronchogenic Carcinoma (Lung Cancer),
Cigarette Smoking, Emphysema, Asthma, Osteoporosis,
-� Aseptic Necrosis of Hip - from Steroids for Asthma
Signed by: Jeffrey Selby, M.D.
421 Chestnut
Evansville IN 47711
Place of burial Columbia White Church Cemetery
or removal:
� Princeton IN 47670
Date of burial:
, Funeral home:
S E A L
12/29/1998
Colvin Funeral Home, Inc.
425 N. Main St.
Princeton IN 47670
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Signed by �'?,. � �r!:_^.,.Y�; ..... : �.:�_.,'-�7
Gibson�County HeaYth Commissioner
Oakland City, Indiana O1/12/99
Address Date
Recorded locally in Book No. 13 Page No. 80 Filed: O1/12/1999