Death Certificate - White, Donald_5/26/2009� �
RECORD OF DEATH
GIBSON COliNTY DEPARTil4ENT OF HEALTH
PRINCETON. I�DIA\A
THIS IS TO CERTIFI'. that our records shou• DOr'ALD [dHITE
Lecember 28, 1999 a� 7:45 PM Wirth Reeional Hospital Oakland City. Indiana
momh day vear hourofdea�h srteet.hospiiaLrural
Age at Death 71 Ses Male Color�hite_\9ariial Staws Married
yenr= write whether married or single
Primarv cau_=e of death �i��en �va� �cute Mvocardial Infarction, 10 Minutes
Type 2 U�1 Chronic Atrial Fibrillation and Chronic Co
Si�nedby Terry Genihausen, D.O. Hwy 64 East Oakland City, Indiana
physician or roroner addres=
tive Heart Failure.
Place of burial or remova� Mt Olive Mt Olvmous, Indiana
name o( cemeterv addrees
Dateofburial .lanuarv 1, 2000 Lamb—Basham Memorial Chapel 226 E. Washinaton Oakland City,
Funerel Direetor address
Indiana
S E.�L
Recorded locally in book \'0 13 Page \'0 108
a�.�. ei����
Gihson Countv Health Commissioner
Princzton, Indiana Januarv 3, 2000
addreas date
Januarv 3, 2000
�
� O��
� �
� 6
�Py ry � �� ���
�o�
P
V 6`�JaSJ
G�
O�
G�ey
