Date: 02 March 1950
Cert: 05582
Place of Death: County: Knott
City or Town: Rural
Length of stay (in this place): All of life
Street address or location: Mousie, Ky.
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural If rural
given precinct: Mousie, Ky.
Full Name: Luther BOLEN
Date of Death: 02 March 1950
Sex, Color or Race, Marital Status: Male, White, Never Married
Date of Birth: 21 December 1928
Age: 21 years
Usual Occupation: None
Kind of Industry or business: None
Birthplace: Knott Co.
Father's Name: Lee BOLEN
Mother's Maiden Name: Polly BOLEN
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Lee BOLEN
Disease/condition directly leading to death: Pulmonary
Paralysis
Interval between onset and death: (blank)
Due to: Pyramidal cell (illegible) degeneration
Interval between onset and death: 10 years
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
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 Life to
(blank), that I last saw the deceased alive on (blank), and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: 12 March 1950
Address: Lackey, Ky.
Signature: C. B. Ison, M.D.
Burial, Cremation or Removal: Burial
Date: 04 March 1950
Name of Cemetery or Crematory: Bolen
Location: Knott Co., Ky.
Date received by local registrar: 20 March 1950
Registrar's Signature: Rose B. Craft
Funeral director/address: Hindman Funeral Home, Hindman, Ky.
Transcribed by Debbie Tamborski, 10 January 2011 |