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DEATH
CERTIFICATE
MAY CAMPBELL
Date 18 March 1949
Cert: 06862
Place of Death: County: Fayette City or Town: Lexington, Ky.
Length of stay in hospital or community: 45
Name of Hospital or Institution: Eastern State Hospital
Usual Residence of Deceased: State: Kentucky County: Knott
City or Town: Garner
Full Name: May CAMPBELL
Date of Death: 18 March 1949
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 15 October 1915
Age: 33 years
Usual Occupation: Housewife
Kind of Industry or business: (blank)
Birthplace: Perry County, Kentucky
Father's Name: Henry BACK
Mother's Maiden Name: Maggie FRALEY
Was deceased in ever in armed forces: No
Social Security No.: (blank)
Informant: Hospital Records
Disease or condition directly leading to death: Lobar
pneumonia
Interval between onset and death: 2 weeks
Due to (b): Syphilis
Interval between onset and death: 15 years
Due to (c): Psychosis
Interval between onset and death: 4 weeks
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings for operation: (blank)
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 04 March 1949
to 18 March 1949, that I last saw the deceased alive on 18
March 1949, and that death occurred on the date stated above
at (blank), from the causes and on the date stated above.
Date signed: 18 March 1949
Address: Eastern State Hospital
Signature: Oreena F. Knepper, M.D.
Burial, Cremation or Removal: Removal
Date: 1949
Name of Cemetery or Creamatory: (blank)
Location: Hazard, Kentucky
Date received by local registrar: 06 April 1949
Registrar's Signature: D. A. Furlong
Funeral director and address: Lowe F.
Home, Merritt Martin, Lex., Ky.
Transcribed by Debbie Tamborski, 15 February 2010 |
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