Date: 23 May 1953
Cert: 16999
Place of Death: County: Knott
City or Town: Spider, Ky. (Rural)
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Spider Rural Street Address:
(blank)
Full Name: William BLAIR
Date of Death: 23 May 1953
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 25 November 1877
Age: 75 years
Usual Occupation: (blank)
Kind of Industry or business: Farmer
Birthplace: Letcher Co., Ky.
Father's Name: Steve BLAIR
Mother's Maiden Name: Martha POLLY
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Willard BLAIR
Disease or condition directly leading to death:
Arteriosclerosis
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 23 May 1953 to
23 May 1952, that I last saw the deceased alive on (illegible), and
that death occurred at 12, from the causes and on the
date stated above.
Date signed: 29 May 1953
Address: Hindman, Ky.
Signature: J. W. Duke
Burial, Cremation or Removal: Burial
Date: 25 May 1953
Name of Cemetery or Crematory: Amburgey Cemetery
Location: Spider, Ky.
Date received by local registrar: 29 May 1953
Registrar's Signature: Rose B. Craft
Funeral director & address: John Everage, Hindman,
Ky.
Transcribed by Debbie Tamborski, 05 February 2011 |