Death Certificate - Stevens, Agnes F_12/8/1992�• � i �
GSBSON COUNTY D�.PARTMF.NT OF HEALTH
800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
R E C O R D O F D E A T H
THIS IS TO CIIYfIFY
that according to the records of the Gibson County Department of Health,
AGNES F. STEVENS
Died on 05/25/1992 at 2:03 A.?1.
Gibson General Hospital
1808 Sherman Drive
Princeton IN 47670
Age at death : 78 Years Sex: F
Marital Status: `tarried Color: White
Cause of death: Anoxic Encephalopathy
Cardiac Arrest
Arteriosclerotic Heart Disease
Signed by: arun C. Kumar, ?1D
105 Y. 2nd Ave.
Princeton IN 47670
Place of buriai I.0.0.£.
or removal:
Princeton ZV 47670
Date of burial: OS/27/1992
Funeral home: Colvin Funeral Home, Inc.
425 \. Main St.
Princeton IV 47670
S E A L
Signed bv "�'��') '/���,��''7�_S��/'°° �
Gibson C�Healt omm�sioner
Oakland Citv, Indiana 12/O8�
Address Date
Recnrded Iocal!� in Book \�o. 12 Pa�e \o. 39 Filed: 0�/''!?/i9`-'='