DEATH CERTIFICATE

STEPHEN ADAMS

 

Date:  21 February 1949
Cert:  05621
Place of Death: County: Knott      City or Town: Red Fox  Rural
Length of stay (in this place): (blank)
Name of Hospital or Institution: None     On Breedings Creek
Usual Residence of Deceased: State: Kentucky   County: Knott
City or Town:  Red Fox     Rural    Street Address: (blank)
Full Name:  Stephen ADAMS
Date of Death:  21 February 1949
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth:  18 August 1880
Age:  68 years
Usual Occupation:  Miner
Kind of Industry or business:  Coal Mining
Birthplace:  Letcher Co., Ky.
Father's Name:  Dan ADAMS
Mother's Maiden Name:  Nancy ADAMS
Was deceased ever in armed forces: No
Social Security No.:  404-24-8030
Informant:  Ellis ADAMS
Disease condition directly leading to death: Cancer - Abdomen
Interval between onset and death:  (blank)
Due to:  (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy:  No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from (blank) to (blank), that I last saw the deceased alive on (blank), and that death occurred at (blank), from the causes and on the date stated above.
Date signed:  08 March 1949
Address:  Hindman, Ky.
Signature:  J. W. Duke, M.D.
Burial, Cremation or Removal:  Burial
Date:  22 February 1949
Name of Cemetery or Crematory:  Adams Cemetery
Location:  Hale Br., Breedings Creek, Knott Co., Ky.
Date received by local registrar:  08 March 1949
Registrar's Signature:  Rose B. Craft
Funeral director & address:  Friends, Red Fox, Ky.
Transcribed by Debbie Tamborski, 02 January 2011