Date: 23 April 1947
Cert: 16051
Place of Death: County: Knott City or
Town: Sasfrass, Ky.
Street Number or Location: At Home
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Sasfrass, Ky.
Full Name: Ellen CALDWELL
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Roy CALDWELL
Age of husband or wife if alive: (blank)
Birth date of deceased: (blank)
Age: 50 years
Birthplace: Virginia
Occupation: Housewife
Industry or business: (blank)
Father Name: Fate SNOW
Father Birthplace: Virginia
Mother Maiden Name: Kathern SNOW
Mother Birthplace: Virginia
Informant: Roy CALDWELL, Sassafras, Ky.
Burial Place: Sasfrass, Ky., Knott Co.
Date: 24 April 1947
Signature of funeral director: Maggard & Blair F. H.
Hazard, Ky., by R. E. Cox
Date received by local registrar: 30 July 1947
Registrar's Signature: Rose B. Craft
Date of Death: 23 April 1947
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Pulmonary Tuberculosis
Duration: (blank)
Due to: (blank)
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. L. Combs, M.D., Hazard, Ky.
Date signed: 25 April 1947
Transcribed by Debbie Tamborski, 16 December 2010 |