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DEATH
CERTIFICATE
LULA ANDERSON
Date 25 October 1929
Cert: 27559
Place of Death: Vot. Pct: M. E. Hospital, Pikeville, Pike Co.,
Ky.
Full Name: Lula ANDERSON
Residence: Garrett, Ky.
Length of Residence in city where death occurred:
(blank)
Sex, Color or Race, Marital Status: Female, White,
Single
Husband or Wife of: (blank)
Date of Birth: (blank)
Age: 26 years
Occupation: Housework
Birthplace: Kite, Ky.
Father Name: Cicero ANDERSON
Birthplace Father: N.C.
Mother Maiden Name: Rhoda JOHNSON
Birthplace Mother: Floyd Co., Ky.
Informant/Address: Elizabeth ANDERSON, Garrett, Ky.
Filed: 25 October 1929
Registrar: J. C. Wright
Death of Date: 25 October 1929
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw h-- alive on (blank), and that death
occurred on the date stated above at 8 a.m.
Cause of Death: Shock following operation
for perforated (illegible)
Duration: (blank)
Contributory: (blank)
Duration: (blank)
Where was disease contracted if not at place of death?:
(blank)
Did an operation precede death: (blank) Date: (blank)
Was there an autopsy: (blank)
What test confirmed diagnosis: (blank)
Signed/Address: Paul Gronnernd, M.D., 25
October 1929, Pikeville, Ky.
Place of Burial or Removal: Garrett, Ky.
Date of Burial: 27 October 1929
Undertaker/Address: J. W. Call & Son, Pikeville, Ky.
Transcribed by Debbie Tamborski, 27 March 2010 |
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