Date: 09 October 1950
Cert: 23322
Place of Death: County: Knott
City or Town: Dry Creek, Ky.
Length of stay (in this place): 01 days
Name of Hospital or Institution: Stumbo Memorial
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Dry Creek Street Address:
(blank)
Full Name: Marie BATES
Date of Death: 09 October 1950
Sex, Color or Race, Marital Status: Female, White, Infant
Date of Birth: 14 February 1950
Age: 07 months, 25 days
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Knott Co.
Father's Name: Joe BATES
Mother's Maiden Name: Frankie HALL
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Joe BATES
Disease or condition directly leading to death: Pseudomonas
Enteritis
Interval between onset and death: 05 days
Due to (b): Dehydration
Due to (c): Acidosis
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
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 08 October 1950 to
09 October 1950, that I last saw the deceased alive on 09
October 1950, and
that death occurred at 2:45 p.m., from the causes and on the
date stated above.
Date signed: (illegible)
Address: Lackey, Ky.
Signature: Martha A. Loving, M.D.
Burial, Cremation or Removal: Burial
Date: 10 October 1950
Name of Cemetery or Crematory: Family
Location: Dry Creek, Knott Co., Ky.
Date received by local registrar: 29 November 1950
Registrar's Signature: Rose B. Craft
Funeral director & address: John C. Hall, Martin,
Ky.
Transcribed by Debbie Tamborski, 10 January 2011 |