Death Certificate - Thomas, Hollis Wilbur_8/22/2000GIBSON �UNTY DEPARTMEI�OF HEALTH
800 S. Prince St.
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RECORD OF DEATH
THIS ZS TO CERTIFY
that according to the records of the Gibson County Department of Health,
HOLLIS WILBUR THOMAS
Died on 08/26/1999 at 2:20PM
Residence
R.R.# 1 Box 42
Princeton IN
Age at death . 74 Years Sex: M
Marital Status: Married Color: White
Cause of death: Cardiac Arrest, Refractory CHF
Renal Failure
Signed by: Satyam Tatineni
415 West Columbia St.
Evansville IN 47710
Place of burial Columbia White Church Cemetery
or removal:
Princeton IN 47670
Date of burial: 08/29/1999
Funeral home:
S E A L
Colvin Funeral Home, Inc.
425 N. Main St.
Princeton IN 47670
Signed by �����'e �`�'�
Gibson County Health C issioner
Oakland City, Indiana 09/07/99
Address Date
Recorded locally in Book No. 13 Page No. 101 Filed: 09/07/1999