Date: 26 December 1941
Cert: 29452
Place of Death: County: Knott City or
Town: Hindman
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Hindman
Full Name: Denver AMBURGEY
If Veteran Name War: 1st World War
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Madge D. AMBURGEY
Age of husband or wife if alive: 35 years
Birth date of deceased: 26 September 1899
Age: 42 years, 03 months
Birthplace: Hindman, Knott Co., Ky.
Occupation: (?Plasturer?)
Industry or business: (blank)
Father Name: Robert H. AMBURGEY
Father Birthplace: Hindman, Knott Co.
Mother Maiden Name: Lucinda ADAMS
Mother Birthplace: Knott Co.
Informant: Mrs. Denver AMBURGEY, Hindman, Ky.
Burial Place: Hindman, Ky.
Date: 27 December 1941
Signature of funeral director: Engle Fun., Hazard, Ky.
Date received by local registrar: 02 January 1942
Registrar's Signature: Ida Livingston
Date of Death: 26 December 1941
I hereby certify that I attended deceased from 19 December
1941 to
26 December 1941, that I last saw him alive on 26 December
1941, and that death occurred on the date stated above at 8
a.m.
Immediate cause of death: Hypertension
Duration: (blank)
Due to: Ulcer of stomach
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: J. W. Duke, M.D., Hindman
Date signed: 02 January 1942
Transcribed by Debbie Tamborski, 08 October 2010 |