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DEATH
CERTIFICATE
JENNINGS BRYAN BRASHEAR
Date 02 November 1939
Cert: 28205
Place of Death: County: Madison City or Town:
Richmond, Ky.
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky County: Madison
City or Town: Richmond Street No.:
Fourth Street
Full Name: Jennings Bryan BRASHEAR
If Veteran Name War: World
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Gertrude BRASHEAR
Age of husband or wife if alive: (blank)
Birth date of deceased: 28 November 1896
Age: 42 years, 11 months, 05 days
Birthplace: Knott Co., Ky.
Occupation: Merchant
Industry or business: Grocery Store
Father Name: Hiram P. BRASHEAR
Father Birthplace: Perry Co., Ky.
Mother Maiden Name: Sarah STACEY
Mother Birthplace: Perry Co., Ky.
Informant: Herman BRASHEAR, R. #3, Richmond, Ky.
Burial Place: Richmond Cemetery
Date: 04 November 1939
Signature of funeral director: Oldham, Roberts & Powell, Inc.,
Richmond, Ky.
Date received by local registrar: 04 November 1939
Registrar's Signature: (illegible) Wilson
Date of Death: 02 November 1939
I hereby certify that I attended deceased from 02 November
1939 to 02 November 1939, that I last saw him alive on no
date, and that death occurred on the date stated above at 9:30
p.m.
Immediate cause of death: Sudden heart Block
Duration: (blank)
Due to: Don't know
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: M. M. Robinson, Richmond, Ky.
Date signed: 03 November 1939
Transcribed by Debbie Tamborski, 01 May 2010 |
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