Death Certificate - Terry, Maxine M_6/4/2009GIBSON COUNTY DEPARTM T OF HEALTH
• 800 S. Prince �.
Princeton, Indiana 47670
812-385-3831
RECORD OF DEATH
THIS IS TO CBRTIFY
that according to the recorde of the Dibson County Department of Health,
MA%INS M. TBRRY
Died on 02/O1/2007 at 5:20AM
Gibson General Hospital
1808 Sherman Drive
Princeton IN 47670
Age at death . 78 Years
Marital Status: Widowed
Sex: F
Color: white
Cause of death: Non Operative Megaelon Bowel Obstruction,
Diabetes Mellitus Cardiac Dysrhythmia, Dementia.
CA Colon with resection.
Manner of death: Natural
Signed by: Bruce C. Brink, Jr., D.O.
410 N.Main
Princeton ZN 47670
Place of burial Decker Cemetery
or removal:
Patoka. ZN 47666
Date of burial: 02/04/2007
Puneral home: Colvin Funeral Home, Inc.
S E A L
425 N. Main St.
PiinCeton IN 476'IO
signed by �� G' i��%`�"'�`�! ��K/
Gibson County Health Comm ssioner
Princeton, Indiana 06/04/09
Address Date
Recorded locally in Book No. 2/2007 Page No
� - �I-D9
Filed: 02/06/2007
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