Date: 02 June 1951
Cert: 14591
Place of Death: County: Knott
City or Town: Lackey, Ky. Rural
Length of stay (in this place): 03 Days
Name of Hospital or Institution: Stumbo Memorial
Hospital
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Lackey Rural Street Address:
(blank)
Full Name: Wayne Edward BATES
Date of Death: 02 June 1951
Sex, Color or Race, Marital Status: Male, White, Infant
Date of Birth: 31 May 1951
Age: 03 days
Usual Occupation: None
Kind of Industry or business: None
Birthplace: Lackey, Ky.
Father's Name: Edward BATES
Mother's Maiden Name: Ova Mae MOORE
Was deceased ever in armed forces: No
Social Security No.: None
Informant: Edward BATES
Disease or condition directly leading to death:
Hemorrhage from Bowels
Interval between onset and death: (blank)
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 31 May 1951 to
02 June 1951, that I last saw the deceased alive on 02 June
1951, and
that death occurred at 8 p.m., from the causes and on the
date stated above.
Date signed: 25 July 1951
Address: Lackey, Ky.
Signature: C. M. Aker, M.D.
Burial, Cremation or Removal: Burial
Date: 03 June 1951
Name of Cemetery or Crematory: Dry Creek Cemetery
Location: Topmost, Ky.
Date received by local registrar: 31 July 1951
Registrar's Signature: Rose B. Craft
Funeral director & address: Cook & Hopkins, Estill,
Ky.
Transcribed by Debbie Tamborski, 17 January 2011 |