Death Certificate - Siekman, Daniel Irvan_7/10/2003� !
GIBSON COUNTY DEPARTMENT OF HEALTH
800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
RECORD OF DEATH
THZS IS TO CBRTIPY
that according to the records of the Gibaoa County Department of Health,
DANIBL IRVAN SISKMAN
Died oa 06/09/2003 at 1:SSAM
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� # 3, Box 208
Oakland City IN 47660
Age at death . 87 Years
Marital Status: Married
Sex: M
Color: White
Cause of death: Acute Myocardial In£arction, Congestive Heart Failure,
Renal Insufficiency, Aortic Stenosis
Signed by: Steven R. Shoemaker M.D.
1116 Millis Ave. Suite 101
Boonville, IN
Place of burial Lynnville Cemetery
or removal:
Lynnville IN 47619
Date of burial: 06/11/2003
Funeral home: Pemberton-Bradley Fluieral Home
S E P L
Box 245
Lynnville IN 47619
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Signed by
Gibson County Health Commissioner
Princeton, Zndiana 06/25/03
Address Date
Recorded locally in Book No. 14 Page No. 65 Filed: 06/25/2003