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DEATH
CERTIFICATE
JOHN BAKER
Date 08 January 1951
Cert: 03358
Place of Death: County: Leslie City or
Town: Big Rock
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County: Leslie
City or Town: Big Rock
Full Name: John BAKER
If Veteran Name War: Spanish Am.
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Polly J. BAKER
Age of husband or wife if alive: (blank)
Birth date of deceased: 15 March 1873
Age: 86 years
Birthplace: Knott County
Occupation: Farmer
Industry or business: (blank)
Father Name: Wm. BAKER
Father Birthplace: Ky.
Mother Maiden Name: Polly MELTON
Mother Birthplace: Leslie Co., Ky.
Informant: William DIXON, Hyden, Ky.
Burial Place: Buried
Date: 09 January 1951
Signature of funeral director: Family, Big Rock, Ky.
Date received by local registrar: 15 February 1951
Registrar's Signature: Lottie Roberts
Date of Death: 08 January 1951
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Probably Heart Attack
Due to: Arteriosclerosis
Duration: 05 years No Doctor
called
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: Manten B. Cornett, Hyden, Ky.
Date signed: 14 February 1951
Transcribed by Debbie Tamborski, 22 July 2010 |
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