Date: 20 March 1947
Cert: 11579
Place of Death: County: Knott Co. City or
Town: Lackey, Ky. Rural
Name of Hospital or Institution: Stumbo Memo. Hosp.
Length of stay in hospital or community: 03 days
Usual Residence of Deceased: State: Ky.
County: Floyd
City or Town: Wayland
Full Name: High CAUDILL
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Martha CAUDILL
Age of husband or wife if alive: 43 years
Birth date of deceased: 13 March 1902
Age: 45 years, 00 months, 07 days
Birthplace: Knott Co.
Occupation: Miner
Industry or business: Coal
Father Name: Ed WADDLES
Father Birthplace: Don't Know
Mother Maiden Name: Eviline CAUDILL
Mother Birthplace: Knott Co.
Informant: W. M. COOK, Wheelwright, Ky.
Burial Place: Wayland, Ky.
Date: 23 March 1947
Signature of funeral director: G. D. Ryan, Martin, Ky.
Date received by local registrar: 31 May 1947
Registrar's Signature: Rose B. Craft
Date of Death: 20 March 1947
I hereby certify that I attended deceased from 17 March 1947 to
20 March 1947, that I last saw him alive on 20 March 1947, and
that death occurred on the date stated above at 2 p.m.
Immediate cause of death: Heart attack
Duration: 02 days
Due to: Coronary occlusion
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. M. Aker, M.D., Lackey, Ky.
Date signed: 31 May 1947
Transcribed by Debbie Tamborski, 16 December 2010 |