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Death Certificate - Thompson, Sanford Ralph_1/16/2002GI�N COUNTY DEPARTMEN�F HEALTH 800 S. Prince St. Princeton, Indiana 47670 812-385-3831 RECORD OF DEATH THIS IS TO CBRTIFY that according to the zecorda of the Gibaoa County Departmeat of Health, SANFORD RALPH THOMPSON Died on O1/09/2002 at 9:10AM Gibson General Hospital 1808 Sherman Drive Princeton IN 47670 Age at death . 79 Years Marital Status: Married Sex: M Color: white Cause of death: Chronic Renal Failure (several weeks), ASHD-(previous MI), Epiodic AF, Cognitive Disorder (small vessel disease) Signed by: William R. Wells, hID 510 N.Main St. - Princeton IN 47670 Place of burial Shiloh Cemetery or removal: HdzletOn IN 47640 Date of burial: O1/12/2002 Funeral home: Colvin Funeral xome, Znc. 425 N. Main St. Princeton IN 47670 Signed by S E A L Recorded locally in Book No. 14 O�� �O��I QOQ � Q� I'1 � �pq�00��f3 Jl � � �~ � JNiv 1� 2002 C:°:0': �0'_9.."! :.UD!TOR � �. ����� County Health Commissioner PLiRC2tOn, II1didRd O1/14/02 Address Date Page No. 29 Filed: O1/14/2002