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DEATH
CERTIFICATE
HENRY G. BLEVINS
Date 03 February 1950
Cert: 10826
Place of Death: County: Perry City or Town:
Hazard
Length of stay in hospital or community:
Name of Hospital or Institution: Mount Mary Hosp.
Usual Residence of Deceased: State: Ky. County: Knott
City or Town: Sassafras, Ky.
Full Name: Henry G. BLEVINS
Date of Death: 03 February 1950
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 30 March 1904
Age: 44 years
Usual Occupation: (blank)
Kind of Industry or business: Miner
Birthplace: Va.
Father's Name: Charlie BLEVINS
Mother's Maiden Name: Ollie ODUM
Was deceased in ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Lottie BLEVINS
Disease or condition directly leading to death:
Hypertensive Heart Disease & congestive heart failure
Interval between onset and death: about 02 years
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings for operation: (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 March 1948 to
03 February 1950, that I
last saw the deceased alive on 03 February 1950, and that death occurred on
the date stated above at (blank), from the causes and on the date
stated above.
Date signed: 15 May 1950
Address: Hazard, Ky.
Signature: Martin Palmer
Burial, Cremation or Removal: Burial
Date: 05 February 1950
Name of Cemetery or Creamatory: Cornett Hill Cem.
Location: Sassafras, Ky.
Date received by local registrar: 15 May 1950
Registrar's Signature: Georgie Pendleton
Funeral director and address: Maggard & Garrett, Hazard,
Ky.
Transcribed by Debbie Tamborski, 16 February 2010 |
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