Death Certificate - Youngson, Ada Helen_1/4/2002...�
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GIBS� COUNTY DEPARTMENT� HEALTH
' ° 800 S. Prince St.
' ,,. Princeton, Indiana 47670
� 812-385-3831
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RECORD OF DEATH
THIS IS TO CSRTIFY,t , .
that according Eo-the records of the Gibsoa County Department of Health,
' - • ADA HBLEN YOIINGSON
. Died oa 12/09/2001 at 7:SOAM
f -- Gibson General Hospital
� 1808 Sherman Drive
" PrinCetOR ZN 47670
Age at death . 79 Years Sex: F
Marital Status: Married Color: White
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Cause of death: Staphylococcus Aureus Septicemia (6 days),
ASHD,- Previous MI'S - CHF, Anemia
Peripheral Vascular Disease
Signed by: William R. Wells, NID
510 N.Main St.
PriRCetOn IN 47670
Place of burial Columbia White Church Cemetery
or removal:
Princeton ZN 47670
Date of burial: 12/13/2001
Funeral home: Colvin Funeral Home, Znc.
425 N. Main St.
Princeton IN 47670 -
S E A L
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Signed by
Gibson County Health Commissioner
Princeton, Indiana 12/12/O1
Address Date
Recorded locally in Book No. 14 Page No. 27 Filed: 12/12/2001