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DEATH
CERTIFICATE
DELTA A. AMBURGY
Date 10 October 1944
Cert: 28213
Place of Death: County: Perry City or
Town: Hazard
Name of Hospital or Institution: Hazard Hosp. Co.
Length of stay in hospital or community:
Usual Residence of Deceased: State: Ky.
County: Letcher
City or Town: Littcarr
Full Name: Delta A. AMBURGY
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 04 October 1901
Age: 43 years, 06 days
Birthplace: Knott County, Ky.
Occupation: Farming
Industry or business: (blank)
Father Name: Wiley J. AMBURGY
Father Birthplace: Knott County, Ky.
Mother Maiden Name: Nancy HONEYCUT
Mother Birthplace: Knott County, Ky.
Informant: W. J. AMBURGEY, Litt Carr, Ky.
Burial Place: Littcar, Ky.
Date: 11 October 1944
Signature of funeral director: Maggard Funeral, Hazard, Ky.
Date received by local registrar: 05 December 1944
Registrar's Signature: (blank)
Date of Death: 10 October 1944
I hereby certify that I attended deceased from 06 October 1944 to
10 October 1944, that I
last saw him alive on 10 October 1944, and that death occurred on the date
stated above at 2:00 a.m.
Immediate cause of death: Empyema (rt)
Due to: Bronchial pneumonia
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: Chris S. Jackson, M.D., Hazard, Ky.
Date signed: 10 October 1944
Transcribed by Debbie Tamborski, 06 February 2010 |
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