Date: 09 April 1944
Cert: 10291
Place of Death: County: Montgomery City or Town: Rural
Street No. or Location: Liver Road
Length of stay in hospital or community: 04 months
Usual Residence of Deceased: State: Kentucky County: Montg.
City or Town: Mt. Sterling Rural Street No.: R. R. #2
Full Name: Robert R. ADAMS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 26 September 1927
Age: 16 years, 06 months, 04 days
Birthplace: Hindman, Ky., Knott County
Occupation: Farm Laborer
Industry or business: (blank)
Father Name: Richard ADAMS
Father Birthplace: Ky.
Mother Maiden Name: Elizabeth WATTS
Mother Birthplace: Ky.
Informant: Johnie MARTIN, Mt. Sterling, Ky.
Burial Place: Hindman, Ky.
Date: 12 April 1944
Signature of funeral director: A. L. Mitchell, Mt. Sterling, Ky.
Date received by local registrar: 28 April 1944
Registrar's Signature: Mrs. Ray W. Sueff
Date of Death: 09 April 1944
I hereby certify that I attended deceased from (blank) to (blank), that I last saw him alive on (blank), and that death occurred on the date stated above at 5 p.m.
Immediate cause of death: Gun shot would in left side, going through the heart
Duration: Instant death
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: Accidental homicide
Date of occurrence: 09 April 1944
Where did injury occur: on farm while out hunting
While at work: (blank)
Means of injury: 12 Ga. shot gun
Signature & Address: A. L. Mitchell, Deputy Coroner, Mt. Sterling, Ky.
Date signed: 10 April 1944
Transcribed by Debbie Tamborski, 02 June 2010