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DEATH
CERTIFICATE
SYNTHA BACH
Date 14 September 1932
Cert: 20588
Place of Death: Voting Pct: Keck, Breathitt Co., Ky.
Full Name: Syntha BACH
Residence: (blank)
Length of Residence in city where death occurred:
(blank)
Sex, Color or Race, Marital Status: Female, White,
Widowed
Husband or Wife of: Isaac BACH
Date of Birth: 25 May 1844
Age: 88 years, 03 months, 20 days
Occupation: Housewife
Birthplace: Knott Co.
Father Name: A. WALKER
Birthplace Father: unknown
Mother Maiden Name: Polly ? [sic]
Birthplace Mother: unknown
Informant/Address: Mrs. H. H. MILLER, Jackson, Ky.
Burial Cremation Removal Place: Buckhart, Ky.
Date: 15 September 1932
Undertaker/Address: J. R. Blake & Son, Jackson, Ky.
Filed: 08 October 1932
Registrar: Mrs. A. W. Brown
Death of Date: 14 September 1932
I hereby certify, That I attended deceased from (blank) to
(blank), that I last saw h-- alive on (blank), death is said
to have occurred on the date stated above, at 1 p.m.
Cause of Death: Has had no doctor for several years.
Died with old age.
Date of onset: (blank)
Contributory causes: (blank)
Name of operation: (blank)
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred
industry, home, public place: (blank)
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: (blank)
Signed/Address: (blank)
Transcribed by Debbie Tamborski, 23 February 2010
Transcribed by Debbie Tamborski, 31 March 2010 |
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