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DEATH
CERTIFICATE
T. J. BENTLEY SR.
Date 12 June 1935
Cert: 29588
Place of Death: Voting Pct.: Beaver, Floyd Co., Ky.
Full Name: T. J. BENTLEY Sr.
Residence: (blank)
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Mary BENTLEY
Date of Birth: 1850
Age: 85 years
Occupation: Farming
Birthplace: Knott Co., Ky.
Father Name: Sol. BENTLEY
Birthplace Father: Knott Co.
Mother Maiden Name: Susann HAGANS
Birthplace Mother: Floyd Co., Ky.
Informant/Address: A. L. ALLEN, Allen, Ky.
Filed: 18 December 1935
Registrar: Theop. Salmons
Death of Date: 12 June 1935
I hereby certify that I attended deceased from 1935 to June
1935, that I last saw h-- alive on (blank), and that death
occurred on the date stated above at (blank)
Cause of Death: Interstition nephritis
Duration: (blank)
Contributory: (blank)
Duration: (blank)
Where was disease contracted if not at place of death?:
(blank)
Did an operation precede death: (blank) Date: (blank)
Was there an autopsy: (blank)
What test confirmed diagnosis: (blank)
Signed/Address: H. H. Mayo, M.D., December
1935, Martin, Ky.
Place of Burial or Removal: Mayo Cemetery
Date of Burial: 13 June 1935
Undertaker/Address: (blank), Allen, Ky.
Transcribed by Debbie Tamborski, 16 April 2010 |
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