Date: 07 October 1944
Cert: 27642
Place of Death: County: Knott City or
Town: Hindman, Ky.
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Hindman Rural
Full Name: James Thomas CAUDILL Jr.
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: 01 September 1944
Age: 01 months, 06 days
Birthplace: Hazard, Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: James Thomas CAUDILL
Father Birthplace: Rowan Co., Ky.
Mother Maiden Name: Dale CORNETT
Mother Birthplace: Hindman, Ky.
Informant: Martha CORNETT, Hindman, Ky.
Burial Place: Cornett Cem.
Date: 07 October 1944
Signature of funeral director: Friends, Hindman
Date received by local registrar: 28 December 1944
Registrar's Signature: Ida Livingston Rose B.
Craft Acting Reg.
Date of Death: 07 October 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 6 a.m.
Immediate cause of death: Congenital weakness
Duration: (blank)
Due to: Very premature birth child weighed about 3
pounds & had to be fed with medicine dropper
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: J. W. Duke, M.D., Hindman, Ky.
Date signed: 28 December 1944
Transcribed by Debbie Tamborski, 08 November 2010 |