Date: 09 March 1944
Cert: 13031
Place of Death: County: Knott City or
Town: Lackey
Name of Hospital or Institution: Stumbo Mem. Hosp.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Floyd
City or Town: Ligon
Full Name: Jimmy 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: Unknown
Age: 08 years
Birthplace: Floyd Co., Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Calvin CAUDILL
Father Birthplace: Floyd Co., Ky.
Mother Maiden Name: Francis SLOAN
Mother Birthplace: Floyd Co., Ky.
Informant: Calvin CAUDILL, Ligon, Ky.
Burial Place: Ligon, Ky.
Date: 10 March 1944
Signature of funeral director: Purchased casket from W.
J. Ryan, Martin, Ky.
Date received by local registrar: 19 March 1945
Registrar's Signature: Rose B. Craft acting per B. Carns
Date of Death: 09 March 1944
I hereby certify that I attended deceased from 05 March 1944 to
09 March 1944, that I last saw him alive on 09 March 1944, and
that death occurred on the date stated above at 5:30 a.m.
Immediate cause of death: Acute Nephritis
Duration: (blank)
Due to: (blank)
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: A. N. Hodge, M.D., Lackey, Ky.
Date signed: 19 March 1945
Transcribed by Debbie Tamborski, 08 November 2010 |