Death Certificate - Tolbert, William B_2/23/2004GIB�N COUNTY DEPARTMEN�F HEALTH
800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
RECORD OF DEATH
THIS IS TO CERTIPY
that accordiag to the records of the Gibaon County Department of Health,
WILLIAM "BIIDDY" TOLBBRT
Died on 02/15/2002 at 6:49am ,
Gibson General Hospital �
1809 Sherman Drive �� I`,� . i1'
Princeton IN 47670 �� �
Age at death : 73 Years Sex: M FEB 2 3 2004
Marital Status: Married Color: White
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Cause of death: Cardiac Arrest (minutes),
GIBSCPI COU`I1v ;.UDl50n '
Cardiac Dysrythmia (minutes),
Chronic Obstructive Pulmonary Disease (years),
Cerebellar Degenesation and Ata�cia
Signed by: xameshbhai P. Patel, hID
105 N. 2nd Ave.
Princeton ZN 47670
Place of burial Columbia White Church Cemetery
or removal:
Princeton ZN 47670
Date of buzial: 02/18/2002
Funeral hoae: Colvin Funeral Home, Inc.
425 N. Main St.
r'=iRC2tOR IN 47670
Signed by � G �/VG�%` " "�
Gibson County Health Commissioner
3 E A L
Princeton, Indiana 02/03/03
Address Date
Recorded locally in Book No. 14 Page No. 33 Filed: 02/21/2002