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DEATH
CERTIFICATE
ALBERT B. CAUDILL
Date 14 March 1940
Cert: 10411
Place of Death: County: Knott City or Town:
Lackey
Name of Hospital or Institution: Stumbo Memorial Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Dema
Full Name: Albert B. CAUDILL
If Veteran Name War: (blank)
Social Security No.: 400-09-6530
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Amanda
Age of husband or wife if alive: 37 years
Birth date of deceased: 14 February 1901
Age: 39 years
Birthplace: Knott Co.
Occupation: Miner
Industry or business: Elkhorn Coal Corp.
Father Name: Alendmander CAUDILL
Father Birthplace: Knott Co.
Mother Maiden Name: Patsy THORNSBURRY
Mother Birthplace: Knott Co.
Informant/Address: Bob LANE, Dema, Ky.
Burial Place: Dema
Date: 17 March 1940
Signature of funeral director/Address: G. D. Ryan, Martin, Ky.
Date received by local registrar: 20 March 1940
Registrar's Signature: Macie Miller
Date of Death: 14 March 1940
I hereby certify that I attended deceased from 11 March 1940 to
14 March 1940, that I last saw him alive on 14 March 1940, and that death
occurred on the date stated above at 8:30 p.m.
Immediate cause of death: Bronchial pneumonia
Duration: (blank)
Due to: appendectomy & ether
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: I. B. Ison, M.D., Lackey, Ky.
Date signed: 16 March 1940
Transcribed by Debbie Tamborski, 16 August 2010 |
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