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DEATH
CERTIFICATE
CAREW BOLEN
Date 24 November 1930
Cert: 16615
Place of Death: Voting Pct: Allen, Floyd Co., Ky.
Full Name: Carew BOLEN
Residence: Hindman, Ky.
Length of Residence in city where death occurred:
(blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Date of Birth: 09 September 1898
Age: 32 years, 02 months
Occupation: Laborer
Birthplace: Vest, Knott Co., Ky.
Father Name: Joseph BOLEN
Birthplace Father: Vest, Knott Co., Ky.
Mother Maiden Name: Margaret STURGILL
Birthplace Mother: Vest, Knott Co., Ky.
Informant/Address: Joseph BOLEN, Mt. Sterling, Ky.
Filed: August 1931
Registrar: Mrs. W. L. Stumbo per B. Carns
Death of Date: 24 November 1930
I hereby certify that I attended deceased from 24 November
1930 to
24 November 1930, that I last saw him alive on 24 November
1930, and that death occurred on the date stated above at 10
a.m.
Cause of Death: Accidently killed by train C & O R.R.
Duration: (blank)
Contributory: (blank)
Duration: 01 days
Where was disease contracted if not at place of death?:
(blank)
Did an operation precede death: No Date: (blank)
Was there an autopsy: No
What test confirmed diagnosis: (blank)
Signed/Address: W. L. Stumbo, M.D., Martin, Ky.
Place of Burial or Removal: Balls Fork, Ky.
Date of Burial: 26 November 1930
Undertaker/Address: G. D. Ryan, Martin, Ky.
Transcribed by Debbie Tamborski, 28 March 2010 |
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