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DEATH
CERTIFICATE
Mrs. DALLIE MAY BLANKENSHIP
Date 24 September 1933
Cert: 23310
Place of Death: Voting Pct. Wayland, Floyd Co., Ky.
Full Name: Mrs. Dallie May BLANKENSHIP
Residence: Wayland, Ky.
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Ralph BLANKENSHIP
Date of Birth: October
Age: 28 years
Occupation: Hswf.
Birthplace: Knott Co., Ky.
Father Name: James NICKELS
Birthplace Father: Va.
Mother Maiden Name: Judy TERRY
Birthplace Mother: Knott Co., Ky.
Informant/Address: Mrs. Charlie HUFF, Wayland, Ky.
Burial Cremation Removal Place: Collins Cemetery
Date: 26 September 1933
Undertaker/Address: Family, Wayland
Filed: 21 October 1933
Registrar: Mrs. M. V. Wicker per B. Carns
Death of Date: 24 September 1933
I hereby certify, That I attended deceased from (blank) to
(blank), that I last saw h-- alive on (blank), death is said
to have occurred on the date stated above, at (blank)
Cause of Death: Tuberculosis of lungs
Date of onset: (blank)
Contributory causes: Chronic Valvular Heart Disease
Name of operation: (blank)
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: (blank)
Signed/Address: M. V. Wicker, M.D., Wayland, Ky.
Transcribed by Debbie Tamborski, 01 April 2010 |
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