Death Certificate - Smith, Marie Ann_4/6/1988RECORD OF DEATH . � O I7- DOSO I
GIBSON COL�NTY DEP.9RT�IENT OF HEALTH
PRIIvCETON,INDLIN.�
THIS IS TO CERTIF'Y, that our records show MARIE ANN SMITH died
Feb. 8, 1986 ,t 9:15 A.M. Gibson General Hospital Princeton Zn.
month day year hour of death street, hospital, ruxal
Age at Death 89• Se,t Female ��or Whiteh�tal Statu� hiarried
years write whether married or aingle
Primary cause of death given was Cardiooulmonary Arrest, Metastatic
Adenocarcinoma of Colon
Signed by �`iicl-inei i:�ip���iC;;,—M.u.
ph;siciaa or coroaer �
t��i:iC2�0ii� i:i.
addtess
Place of burial or removai Union Ridae Neca Haven I1
name of cemetery address
Date of burial Februarv 10 , 1986 Holder' s Owensville In
� FLneral DirecWr address -
SE:�L
�J %�rl�'�, � �,�a
Sign�
Gibson County Health Commissioner
Oakland City, In. 3/3/86
addxs�
Recorded locally in book r�o. 11 Page No. 3 �led: February 12, 1986
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