|
DEATH
CERTIFICATE
BAMER BAKER
Date 18 June 1943
Cert: 18960
Place of Death: County: Perry City or Town:
Hazard
Street No. or Location: Tate St.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Perry
City or Town: Hazard Street No.:
Tate St.
Full Name: Bamer BAKER
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, Colored, Widow
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 07 September 1907
Age: 36 years
Birthplace: Knott Co.
Occupation: House Keeper
Industry or business: (blank)
Father Name: Blain HAGGAN
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Ida SPICER
Mother Birthplace: Jackson, Ky.
Informant: Blain HAGGAN, Jackson, Ky.
Burial Place: Jackson, Ky.
Date: 21 June 1943
Signature of funeral director: Engles, Hazard, Ky.
Date received by local registrar: 01 July 1943
Registrar's Signature: Anna Laura Boulos
Date of Death: 18 June 1943
I hereby certify that I attended deceased from February 1943 to
18 June 1943, that I last saw her alive on 18 June 1943, and
that death occurred on the date stated above at 9:15 p.m.
Immediate cause of death: Pulmonary Tuberculosis
Duration: (blank)
Due to: (blank)
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: Carlow B. Combs, M.D.,
Hazard
Date signed: 20 June 1943
Transcribed by Debbie Tamborski, 30 May 2010 |
|