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DEATH
CERTIFICATE
VIOLET AMBURGEY
Date 16 November 1934
Cert: 02012
Place of Death: Voting Pct.: Colson, Letcher Co., Ky.
Full Name: Violet AMBURGEY
Residence: Colson, Ky.
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Female, White, Child
Husband or Wife of: Child
Date of Birth: 25 October 1934
Age: 22, days
Occupation: Child
Birthplace: Knott Co., Ky.
Father Name: Ballard AMBURGEY
Birthplace Father: Knott Co., Ky.
Mother Maiden Name: Anna HUGHES
Birthplace Mother: Letcher Co., Ky.
Informant/Address: Mack HUGHES, Colson, Ky.
Burial Cremation Removal Place: Logan Cemetery
Date: 17 November 1937
Undertaker/Address: Family, Colson, Ky.
Filed: 31 January 1935
Registrar: J. Don Collins
Death of Date: 16 November 1934
I hereby certify, That I attended deceased from (blank) to
(blank), that I last saw her alive on (blank), death is said
to have occurred on the date stated above, at 9 a.m.
Cause of Death: Birth anomaly (Malformation in utero)
Date of onset: (blank)
Contributory causes: Utero malformation
Name of operation: None Was there an
autopsy: No.
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: None
Nature of injury: (blank)
Related to occupation: No
Signed/Address: R. D. Collins, M.D., Whitesburg, Ky.
Transcribed by Debbie Tamborski, 04 April 2010 |
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