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DEATH
CERTIFICATE
CURTIS BOLEN
Date 15 October 1933
Cert: 24744
Place of Death: Voting Pct. No. 25, Hazard Hospital,
Hazard, Perry Co., KY
Full Name: Curtis BOLEN
Residence: Yellow Mountain, Ky.
Length of Residence: (Life crossed through)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: (blank)
Date of Birth: 11 February 1901
Age: 32 years, 08 months, 04 days
Occupation: Farmer
Birthplace: Yellow Mountain, Knott Co., Ky.
Father Name: Reece T. BOLEN
Birthplace Father: Knott County, Ky.
Mother Maiden Name: Louelza (?MANNS?--illegible)
Birthplace Mother: Kentucky
Informant/Address: Reese T. BOLEN, Yellow Mountain, Ky.
Burial Cremation Removal Place: Yellow Mountain, Ky.
Date: 16 October 1933
Undertaker/Address: H. Engle, Hazard, Ky.
Filed: 28 October 1933
Registrar: J. P. Boggs
Death of Date: 15 October 1933
I hereby certify, That I attended deceased from 15 October
1933 to
15 October 1933, that I last saw him alive on 15 October 1933,
death is said to have occurred on the date stated above, at
1:30 p.m.
Cause of Death: Hemorrhage of brain
Date of onset: 15 October 1933
Contributory causes: Fractured skull automobile accident
Name of operation: None Was there an
autopsy: No
Accident, suicide, homicide: Accident
Date of Injury: 15 October 1933
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
On state highway - Ky.
Manner of injury: Thrown from truck
Nature of injury: (blank)
Related to occupation: No
Signed/Address: J. E. Hagan, M.D., Hazard, Ky.
Transcribed by Debbie Tamborski, 01 April 2010 |
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