Date: 08 August 1947
Cert: 18414
Place of Death: County: Knott City or
Town: Dwarf P.O.
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Dwarf
Full Name: Lee CAUDILL
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White,
Married
Husband or Wife of: Mamie CAUDILL
Age of husband or wife if alive: 31 years
Birth date of deceased: 08 May 1914
Age: 33 years, 03 months, 01 days
Birthplace: Letcher County
Occupation: Miner
Industry or business: Personal Hauler
Father Name: Henry CAUDILL
Father Birthplace: Letcher County
Mother Maiden Name: Rosetta CAUDILL
Mother Birthplace: Letcher County
Informant: Mrs. Lee CAUDILL, Dwarf, Ky.
Burial Place: Line Fork
Date: 11 August 1947
Signature of funeral director: Engle's, Hazard, Ky.
Date received by local registrar: 19 August 1947
Registrar's Signature: Rose B. Craft
Date of Death: 08 August 1947
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 (blank)
Immediate cause of death: Crushed skull other injuries
from auto accident near Dwarf, Ky.
Duration: (blank)
Due to: Information from Undertakers record. I did
not see the person.
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. W. Adkins, M.D., Hazard, Ky.
Date signed: 16 August 1947
Transcribed by Debbie Tamborski, 16 December 2010 |