DEATH CERTIFICATE

WAYNE BLAIR

Date  14 November 1940
Cert:  26572
Place of Death: County: Knott     City or Town: Cody
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.    County: Knott
City or Town:  Cody
Full Name:  Wayne BLAIR
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of:  (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased:  13 November 1940
Age: 12 hours
Birthplace:  Knott Co.
Occupation:  (blank)
Industry or business: (blank)
Father Name:  William McKinley BLAIR
Father Birthplace:  Knott Co.
Mother Maiden Name:  Ezzie FEANCE
Mother Birthplace:  Knott
Informant/Address:  William McKinley BLAIR, Cody 
Burial Place:  Cody 
Date:  15 November 1940
Signature of funeral director/Address: Family
Date received by local registrar:  18 November 1940
Registrar's Signature:  Macie Miller
Date of Death:  14 November 1940
I hereby certify that I attended deceased from (blank) to (blank), that I last saw him alive on (blank), and that death occurred on the date stated above at (blank)
Immediate cause of death:  premature birth
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: Mary Morton, Cody
Date signed:  14 November 1940
Transcribed by Debbie Tamborski, 16 August 2010