Death Certificate - Smith, Charles D_3/4/1997.�a��
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GIBSON �UNTY DEPARTMENT OF�ALTH
800 S. Prince St.
Princeton, Zndiana 47670
� n O 812-385-3831
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RECORD OFDEATH
THIS ZS TO CEATIFY .
that according to the records of the Gibson County Department of Health,
CHARLES D. SMITH
Died on 08/07/1996 at 1:20AM
Wirth Regional Hospital
Hwy 64 West
Oakland City IN 47660 '
Age at death . 65 Years
Marital Status: Married
Sex: M
Color: White
Cause of death: Multiple Organ Failure (days),
Inanition with Debilitation (months)
Carcinomatosis (years),.
Carcinoma of Colbn (.years)
Signed by:
Gerald G. Gray, DO
Hwy 64 West
Oakland City IN 47660
Place of burial Pleasant Ridge Cemetery
or removal:
Date of burial:
Funersl home:
S c A L
Oakland City IN
08/09/1996
Lamb-Basham Memorial Chapel
226 E. Washington
Oakland City IN 47660
Signed by _ "� ���ci'• ,6C�'�''`�
Gibson County He th Commissioner
Oakland City, Indiana 08/13/96
Address Date
Recorded locally in Book No. 13 Page No. 17
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Filed: OS/13/1996