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DEATH
CERTIFICATE
LEWIS BLAIR
Date 08 December 1942
Cert: 19659
Place of Death: County: Clay City or Town:
Garrard
Street No. or Location: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Clay
City or Town: Garrard, Ky.
Full Name: Lewis BLAIR
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Daisy BLAIR
Age of husband or wife if alive: (blank)
Birth date of deceased: 05 September 1883
Age: 59 years, 03 months, 03 days
Birthplace: Knott County
Occupation: Farmer
Industry or business: own farm
Father Name: Elihu BLAIR
Father Birthplace: Knott County
Mother Maiden Name: Sally BACK
Mother Birthplace: Knott County
Informant: Reva BLAIR, Garrard, Ky.
Burial Place: Garrard, Ky.
Date: 09 December 1942
Signature of funeral director: Family, Garrard, Ky.
Date received by local registrar: 30 September 1943
Registrar's Signature: Lillian Wagers
Date of Death: 08 December 1942
I hereby certify that I attended deceased from 01 January 1942 to
01 December 1943 [sic], that I last saw him alive on 05
December 1942, and that death
occurred on the date stated above at (blank)
Immediate cause of death: Chronic nephritis
Duration: (blank)
Due to: (blank)
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: L. H. Wagers, M.D., Manchester
Date signed: 30 September 1943
Transcribed by Debbie Tamborski, 21 May 2010 |
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