Death Certificate - Wallace, James R_4/17/1995�
�i
G I B S O N C O U N T Y D E:P A R T M E N T O F H E A L T H
-. ' 800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
R E C O RD O F D E A T H
_.
THIS IS TO CERTIFY
that according to the records of the Gibson County Department of Health,
JAMES R. WALLACE
I Died on 11/10/1993 at 12:35am
i Gibson General Hospital
1808 Sherman Drive
j Princeton IN 47670
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i Age at death . 74 Years Sex: M
I
I Marital Status: Married Color: White
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� Cause of death: Metastatic Bladder Carcinoma,
� Renal Failure, Diabetes Mellites
Signed by: Arun C. Kumar, MD
105 N. 2nd Ave.
Princeton IN 47670
Place of burial I.O.O.F.
or removal:
Francisco IN 47649
Date of burial: 11/12/1993
Funeral home: Colvin Funeral Home, Inc.
425 N. Main St.
Princeton IN 47670
S E A L
/ ,�, �, y/�� %/
� Signed by Z/J�'J'�_u.rn41�'°ca- .l�r6%
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Gibson County Healffi Commissioner
Oakland City, Indiana 11/24/93
Address Date
Recorded locally in Book No. 12 Page No. 78 Filed: 11/15/1993