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DEATH
CERTIFICATE
REESE T. BOLEN
Date: 13 March 1950
Cert: 05921
Place of Death: County: Montgomery City or Town:
Rural-Camargo
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Kentucky County:
Montgomery
City or Town: Rural-Camargo
Street Address: Camargo
Full Name: Reese T. BOLEN
Date of Death: 13 March 1950
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 07 January 1873
Age: 77 years, 02 months, 06 days
Usual Occupation: Farmer Owner
Kind of Industry or business: Farmer
Birthplace: Knott County, Ky.
Father's Name: R. J. BOLEN
Mother's Maiden Name: Christine GAYHEART
Was deceased ever in armed forces: No
Social Security No.: (blank)
Informant: Tandy BOLEN
Disease or condition directly leading to death:
Arteriosclerotic Heart Disease
Interval between onset and death: 03 years
Due to: (blank)
Other significant conditions: Uremia
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 15 June 1948 to
13 March 1950, that I last saw the deceased alive on 13 March
1950, and
that death occurred at 2:00 a.m., from the causes and on the
date stated above.
Date signed: 14 March 1950
Address: Mt. Sterling, Ky.
Signature: Roy Mason Viasli, M.D.
Burial, Cremation or Removal: Burial
Date: 15 March 1950
Name of Cemetery or Crematory: Family - Bolen
Location: Balds Fork, Knott County, Ky.
Date received by local registrar: 14 March 1950
Registrar's Signature: Elizabeth Wyatt
Funeral director & address: Eastin - Richey, Mt.
Sterling, Ky.
Transcribed by Debbie Tamborski, 14 July 2010 |
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