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Death Certificate - Cleveland, Melvin C_4/26/2016 G I BS O N COUNTY DEPARTMENT OF HEALTH 800 S. Prince St. Princeton, Indiana 47670 812-385-3831 RECORD OF DEATH THIS IS TO CERTIFY that according to the records of the Gibson County Department of Health, MELVIN C . CLEVELAND Died on 10/30/1992 at 11 :04am Gibson General Hospital 1808 Sherman Drive Princeton IN 47670 Age at death : 62 Years Sex: M Marital Status: Married Color: White Cause of death: Metastic Cancer of Lung (2 weeks) , Cancer of Lung (5 months) FILED LjJ APR 2-6 2016 Signed by: William E.Dye, MD n(__ 412 Main GIBSON COUNTY AUDITOR Oakland City IN 47660 Place of burial Mt. Olive or removal : GGGn 6-a(.R"�M 00 Od1 Mt. Olympus IN ? Date of burial: 11/02/1992 Funeral home: Colvin Funeral Home, Inc. 425 N. Main St. Princeton IN 47670 Signed by bit)ereCz4a! liSrAD Gibson County Healthissioner . SEA L Oakland City, Indiana 11/09/92 Address Date Recorded locally in Book No . 12 Page No . 50 Filed : 11/09/1992