Date: 24 November 1944
Cert: 27646
Place of Death: County: Knott City or
Town: Tina, Ky. Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Tina, Ky. Rural
Full Name: Roselee AMBURGEY
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 11 November 1944
Age: 13 days
Birthplace: Tina, Knott Co., Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Otto AMBURGEY
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Arrina COMBS
Mother Birthplace: Knott Co., Ky.
Informant: Rhoda HICKS, Tina, Ky.
Burial Place: Tina, Ky.
Date: November 1944
Signature of funeral director: None
Date received by local registrar: 07 December 1944
Registrar's Signature: Ida Livingston R. B. Craft
Acting Reg.
Date of Death: 24 November 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 (blank)
Immediate cause of death: Infant
Duration: (blank)
Due to: Premature
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, Ky.
Date signed: 08 December 1944
Transcribed by Debbie Tamborski, 07 November 2010 |