Death Certificate - Wallace, James R_3/21/1994� �
GZF3SON COiJN1'Y DEPARTMENT OF HEALTH
' 800 S. Prince St.
_' _ Princeton, lndiana 47670
812-385-3831
a
R E C O RD O F D E A T H
� THIS IS 1'0 CER1'IFY
I that according to the records of the Gibson County Department of Health,
I
I JAMES R. WALLACE
Died on 11!10/1993 at 12:35am
Gibson General Hospital
1808 Sherman llrive
Princeton IN 47670
Age at death : 74 Years Sex: M
Marital Status: Married Color: White
Cause of death: Metastatic Bladder Carcinoma,
Renal Failure, lliabetes Mellites
Sigried by: Arun C. Kumar, Mll
105 N. 2nd Ave.
Princeton IN 47670
Place of burial I.O.O.F.
or removal:
Francisco It� 47649
Date of burial: 11/12/1993
Funeral home: Colvin Fwieral Home, Inc.
425 N. Main St.
Princeton IN 47670
S E A L
�.r J � -}���ji � �dG<.- . �:.{J
Signed by __ ���^'
Gibson County Healt Commissioner
Oakland City, Indiana 11/24/93
Address Date
Recorded lecally in Book No. 12 Page No. 78 Filed: 11/15/1993