|
DEATH
CERTIFICATE
ENON CAUDILL
Date: 19 March 1949
Cert: 04628
Place of Death: County: Floyd City or Town:
Martin
Length of stay (in this place): 01 day
Name of Hospital or Institution: Beaver Valley Hospital
Usual Residence of Deceased: State: Kentucky County:
Floyd
City or Town: Ligon Street Address:
(blank)
Full Name: Enon CAUDILL
Date of Death: 19 March 1949
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 02 August 1899
Age: 49 years
Usual Occupation: Miner
Kind of Industry or business: Coal Mining
Birthplace: Knott Co., Kentucky
Father's Name: Alec CAUDILL
Mother's Maiden Name: Maisie COOK
Was deceased ever in armed forces: (blank)
Social Security No.: 403-01-6341
Informant: Maisie COOK
Disease or condition directly leading to death:
Hypertensive Heart Disease
Interval between onset and death: (blank)
Due to: Bronchial Asthma
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (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 18 March 1949 to
19 March 1949, that I last saw the deceased alive on 19 March
1949, and
that death occurred at 2:30, from the causes and on the
date stated above.
Date signed: 24 March 1949
Address: Martin, Ky.
Signature: Robert M. Sirkle, M.D.
Burial, Cremation or Removal: Burial
Date: 21 March 1949
Name of Cemetery or Crematory: Jack's Creek
Location: Bevinsville, Kentucky
Date received by local registrar: 28 March 1949
Registrar's Signature: Lucy Ransdell
Funeral director & address: G. D. Ryan, Martin,
Kentucky
Transcribed by Debbie Tamborski, 12 July 2010 |
|