Date: 23 March 1953
Cert: 10663
Place of Death: County: Knott
City or Town: Sassafras
Length of stay (in this place): (blank)
Street address or location: Home
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Cody, Ky. Street Address:
(blank)
Full Name: Virginia Lee BACK
Date of Death: 23 March 1953
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 13 September
Age: 25 years
Usual Occupation: Housewife
Kind of Industry or business: Home
Birthplace: Kentucky
Father's Name: Sam COMBS
Mother's Maiden Name: Bertha HAMPTON
Was deceased ever in armed forces: No
Social Security No.: (blank)
Informant: Vadis BACK
Disease or condition directly leading to death: Carcinoma
(femur)
Interval between onset and death: 18 months
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from August 1951 to
23 March 1953, that I last saw the deceased alive on 23 March
1953, and
that death occurred at 6:00 p.m., from the causes and on the
date stated above.
Date signed: 26 March 1953
Address: Allock
Signature: A. B. Pigman, M.D.
Burial, Cremation or Removal: Burial
Date: 26 March 1953
Name of Cemetery or Crematory: Cornett Hill
Location: Sassafras, Ky.
Date received by local registrar: 31 March 1953
Registrar's Signature: Mrs. Rose B. Craft
Funeral director & address: Maggard & Garrett, Hazard, Ky.
Transcribed by Debbie Tamborski, 05 February 2011 |