Date: 14 September 1948
Cert: 21272
Place of Death: County: Knott City or
Town: Lackey
Name of Hospital or Institution: Stumbo Mem.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Floyd
City or Town: Melvin
Full Name: John L. BURGER
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White,
Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 12 July 1948
Age: 02 months, 02 days
Birthplace: Melvin, Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: John BURGER
Father Birthplace: Penn.
Mother Maiden Name: Daisy HALL
Mother Birthplace: Knott Co.
Informant: John BURGER, Melvin
Burial Place: Melvin
Date: 14 September 1948
Signature of funeral director: G. D. Ryan, Martin, Ky.
Date received by local registrar: 15 October 1948
Registrar's Signature: Rose B. Craft
Date of Death: 14 September 1948
I hereby certify that I attended deceased from 14 September
1948 to
14 September 1948, that I last saw him alive on 14 September
1948, and that death occurred on the date stated above at 11
a.m.
Immediate cause of death: Toxemia
Duration: (blank)
Due to: Infectious diarrhea
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: C. M. Aker, M.D., Lackey, Ky.
Date signed: 13 October 1948
Transcribed by Debbie Tamborski, 22 December 2010 |