Date: 27 May 1950
Cert: 14720
Place of Death: County: Knott
City or Town: Lackey
Length of stay (in this place): (blank)
Name of Hospital or Institution: Stumbo Memorial Hosp.
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Lackey Street Address:
(blank)
Full Name: Maudie Mae ADKINS
Date of Death: 27 May 1950
Sex, Color/Race, Marital Status: Female, White, Never Married
Date of Birth: 15 October 1940
Age: 09 years
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Ky.
Father's Name: Everrett ADKINS
Mother's Maiden Name: Leona THORNSBERRY
Was deceased ever in armed forces: No
Social Security No.: (blank)
Informant: Everrett ADKINS
Disease or condition directly leading to death: Drowning
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: Accident
Place of injury: Beaver Creek
City or Town, County, State: Pumpkin Center, Floyd, Ky.
Time of Injury: 27 May 1950, 4:45 p.m.
Injury occurred at work: Not while at work
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: (blank)
Address: Lackey, Ky.
Signature: Martha A. Loving, M.D.
Burial, Cremation or Removal: Burial
Date: 29 May 1950
Name of Cemetery or Crematory: Lackey Cem.
Location: Lackey, Ky.
Date received by local registrar: 27 June 1950
Registrar's Signature: Rose B. Craft
Funeral director & address: (blank)
Transcribed by Debbie Tamborski, 10 January 2011 |