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DEATH
CERTIFICATE
LEWIS BLAIR
Date 09 December 1942
Cert: 05514
Place of Death: County: Clay City or Town:
Garrard, rural
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, rural
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: 23 years
Birth date of deceased: 05 September 1884
Age: 58 years, 03 months, 04 days
Birthplace: Knott Co.
Occupation: Farmer
Industry or business: (blank)
Father Name: Elihu BLAIR
Father Birthplace: Knott Co.
Mother Maiden Name: Sally BACK
Mother Birthplace: Knott Co.
Informant: Mary D. SMITH (X) Her mark, Garrard
Burial Place: Garrard, Ky.
Date: 10 December 1942
Signature of funeral director: Family, Garrard, Ky.
Date received by local registrar: 02 March 1943
Registrar's Signature: Lillian Wagers
Date of Death: 09 December 1942
I hereby certify that I attended deceased from 01 December
1940 to
01 October 1942, that I last saw him alive on (blank), and
that death occurred on the date stated above at 6:00 p.m.
Immediate cause of death: Lobar pneumonia
Duration: 10 days
Due to: Chronic nephritis Duration:
02 years
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,
Ky.
Date signed: 03 March 1943
Transcribed by Debbie Tamborski, 21 May 2010 |
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