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Death Certificate - Smith, Harry W_8/28/2000- - -.. � GIBSON COUNTY DEPARTMEN�OF HEALTH ' ce St 800 S. Prin • � Princeton, Indiana 47670 �J � 812-385-3831 V �J RECORD OF DEATH � A�� 2 8 2U0� G�g$ON THIS IS TO CERTIFY that according to the records of the Gibson County Department of Healt , HARRY W. SMITH Died on OB/21/2000 at Gibson General Hospital 1808 Sherman Drive Princeton IN 47670 Age at death _ 78 Years Marital Status: Married Sex: M Color: White Cause of death: F`Cornary Artery1DiseasetioDiabetes1Mellitus, type II Sigaed by: David D. Christeson, NID 6700 Darmstadt Road Evansville IN 47711 Place of burial Walnut Hill Cemetery or removal: Ft. Branch IN 47648 Date of burial: Funeral home: S E A L OB/25/2000 Colvin Funeral Home, Inc. 425 N. Main St. Princeton IN 47670 ��� � ���� Signed by Gibson County Health Commissioner Princeton Indiana 08/28/00 Address Date Recorded locally in Book No. 13 Page No. 125 Filed: OB/28/2000