Date: 01 February 1954
Cert: #05342
Place of Death: County: Knott City or Town:
Lackey
Length of stay (in this place): (blank)
Name of Hospital or Institution: Stumbo Memorial Hosp.
Usual Residence of Deceased: State: Ky. County:
Floyd
City or Town: Wayland Street Address: (blank)
Full Name: Leona May BEVERLY
Date of Death: 01 February 1954
Sex, Color/Race, Marital Status: Female, White, Never Married
Date of Birth: 29 January 1954
Age: 02 days
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Stumbo Memorial
Father's Name: Cledis BEVERLY
Mother's Maiden Name: Audry MAY
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Cledis BEVERLY
Disease or condition directly leading to death:
Pneumonia
Interval between onset and death: (blank)
Due to: (blank)
Other significant conditions: (blank)
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 29 January 1954 to
01 February 1954, that I last saw the deceased alive on 01
February 1954, and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: 19 March 1954
Address: Lackey, Ky.
Signature: C. M. Aker, M.D.
Burial, Cremation or Removal: Burial
Date: 02 February 1954
Name of Cemetery or Crematory: Turner Cemetery
Location: Wayland, Ky.
Date received by local registrar: 25 March 1954
Registrar's Signature: J. F. Blackerby, State Reg., By:
L. B.
Funeral director & address: Hall Bros., Martin, Ky.
Transcribed by Debbie Tamborski, 17 March 2011 |