Date: 13 January 1944
Cert: 20728
Place of Death: County: Knott City or
Town: Hollybush Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Floyd
City or Town: Estill Rural
Full Name: I. B. CAUDILL
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 27 November 1894
Age: 49 years, 01 months, 16 days
Birthplace: Knott Co., Ky.
Occupation: Farming
Industry or business: (blank)
Father Name: Hardin CAUDILL
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Mary SLONE
Mother Birthplace: Knott Co., Ky.
Informant: B. J. CAUDILL, Lackey, Ky.
Burial Place: Hollybush, Ky.
Date: 17 January 1944
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: 26 September 1944
Registrar's Signature: Ida Livingston
Rose B. Craft Acting Registrar
Date of Death: 13 January 1944
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at 11:00 a.m.
Immediate cause of death: Internal hemorrhage
Duration: (blank)
Due to: Buckshot
Major findings of operations: (blank)
Accident, suicide, or homicide: Homicide
Date of occurrence: 13 January 1944
Where did injury occur: on Farm
While at work: yes
Means of injury: Gun
Signature & Address: W. J. Ryan, Martin, Ky.
Date signed: 16 January 1944
Transcribed by Debbie Tamborski, 07 November 2010 |