Date:   03 January 1942
Cert:   01759 
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:  William Thomas AMBURGY
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White
Husband or Wife of:  (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased:  30 September 1930
Age: 11 years, 03 months, 03 days
Birthplace:  Knott County
Occupation:  Student
Industry or business: (blank)
Father Name:  Marcus AMBURGY
Father Birthplace:  Knott Co.
Mother Maiden Name:  Cassie CAMPBELL
Mother Birthplace:  Knott Co.
Informant:  Marcus AMBURGY, Hindman, Ky.
Burial Place:  Hindman, Ky.
Date:  04 January 1942
Signature of funeral director: Engle Und. & Hdwe. Co., Main St., Hazard, Ky.
Date received by local registrar: 10 January 1942
Registrar's Signature:  (illegible)
Date of Death:  03 January 1942
I hereby certify that I attended deceased from (blank) to (blank), that I last saw him alive on 02 January 1942, and that death occurred on the date stated above at 11 a.m.
Immediate cause of death:  Blood poisoning
Duration: (blank)
Due to: injury to arm  (illegible)
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:  10 January 1942
Transcribed by Debbie Tamborski, 15 October 2010