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DEATH
CERTIFICATE
OCTAVIA FUGATE BLAIR
Date 13 September 1952
Cert: 18657
Place of Death: County: Hardin City or Town:
Fort Knox, Ky.
Length of stay in hospital or community: 30 days
Name of Hospital or Institution: US Army Hospital
Usual Residence of Deceased: State: Kentucky County: Knott
City or Town: Talcum Street
Address: Rural
Full Name: Octavia FUGATE BLAIR
Date of Death: 13 September 1952
Sex, Color or Race, Marital Status: Female, White,
Married
Date of Birth: 15 November 1932
Age: 19 years, 09 months, 28 days
Usual Occupation: House wife
Kind of Industry or business: (blank)
Birthplace: Knott Co., Kentucky
Father's Name: George FUGATE
Mother's Maiden Name: Sally FRANCIS
Was deceased ever in armed forces: No
Social Security No.: (blank)
Informant: George FUGATE
Disease or condition directly leading to death: Subacute
Glomerulonephritis
Interval between onset and death: Admitted to this hosp.
13 August 1952 expired at 12:00 midnight 13 September 1952
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: none
Major findings for autopsy: Same as above
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 13 August 1952 to
13 September 1952, that I
last saw the deceased alive on 13 September 1952, and that death occurred on
the date stated above at 12:00 midnight, from the causes and on the date
stated above.
Date signed: 22 September 1952
Address: Fort Knox, Kentucky
Signature: Leroy Homer, 1st Lt., M.C.
Burial, Cremation or Removal: Burial
Date: 17 September 1952
Name of Cemetery or Creamatory: Fugate Cemetery
Location: Talcum, Kentucky
Date received by local registrar: 25 September 1952
Registrar's Signature: Mrs. Winifred Royally
Funeral director and address: Engle Funeral Home,
Hazard, Ky.
Transcribed by Debbie Tamborski, 20 February 2010 |
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