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DEATH
CERTIFICATE
JOHN CALHOUN
Date 05 June 1941
Cert: 14509
Place of Death: County: Floyd City or Town:
Prestonsburg
Name of Hospital or Institution: Prestonsburg General Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky County: Floyd
City or Town: Cliff (Rural)
Full Name: John CALHOUN
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Minnie CALHOUN
Age of husband or wife if alive: 67 years
Birth date of deceased: 15 October 1860
Age: 80 years, 07 months, 21 days
Birthplace: Knott County
Occupation: Farmer
Industry or business: (blank)
Father Name: Tom CALHOUN
Father Birthplace: Knott Co.
Mother Maiden Name: Jane MUSIC
Mother Birthplace: Floyd County
Informant: Job CALHOUN, Water Gap, Ky.
Burial Place: Water Gap, Ky.
Date: 06 June 1941
Signature of funeral director: E. P. Arnold,
Prestonsburg, Ky.
Date received by local registrar: 12 June 1941
Registrar's Signature: Mrs. Ben Norris
Date of Death: 05 June 1941
I hereby certify that I attended deceased from 29 May 1941 to
05 June 1941, that I last saw him alive on 05 June 1941, and
that death occurred on the date stated above at 7:25 a.m.
Immediate cause of death: Coronary sclerosis
Duration: ? [sic]
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: D. H. Daniel, MD, West Prestonsburg,
Ky.
Date signed: 11 June 1941
Transcribed by Debbie Tamborski, 12 May 2010 |
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