Death Certificate - Toler, John W_4/20/1994�
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G I F3 S O N C O U N T Y D E P AR T M E N T
800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
R E C O R D O F D E A T H
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THIS IS 7'0 CIIiPIFY
that according to the records of the Gibson County Depar�ent of Health,
J01-1N W. TOLER
Died on O1/03/1994 at 1:15 F�1
Gibson Geiieral Hospital
1808 Slierman Drive
Princeton I\' 47670
Age at death : 72 Years
Marital Status: Married
Sex: "1
Color: N'hite
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� Cause of death: Refractory Cai-diac Failure. Ischemic Cardiomyopathy I
� By Pass Graft Closu:•e. Diabetes Mellitus, COPD i
Renal insuffici�ncy ;
� Sigrted by:
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Arun C. tiumar, `iD
105 ,\'. 2nd .ave.
Prince7:oii I\ 476'0
Place of burial Shiloh Cemete�y
or removal:
Hazleto�i I`: 47640
Date of burial: Oi/06/1994
Funeral home: Colvii. Funeral :iome, Inc.
� ' 425 \'. `lsin St.
Pi•incetoa I\ 4?670
S E A L
Sio �ed by �7l �v _./Pi�►
Gibson County Healt ommissioner
Oakland Citv, Indiana O1/07/94
Address Date
Recorded locally in B�ok �'o. 12 Page No. 82 Filed: O1/07/1994
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