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DEATH
CERTIFICATE
MONT CAUDILL
Date 11 January 1938
Cert: 17782
Name: Mont CAUDILL
Place of Death: Voting Pct. Lower Jones Fork #19, Stumbo Mem.
Hosp., Lackey, Knott Co., KY
Residence: (blank)
Length of residence: (blank)
Male, White, Married
Husband or Wife of: Maxie CAUDILL
Birth Date: (blank)
Age: 26 years
Occupation: Miner
Place of Birth: Indian Bottom, Ky.
Name of Father: James CAUDILL
Birthplace Father: Ky.
Maiden Name of Mother: Susie CAUDILL
Birthplace Mother: Ky.
Informant: J. C. CAUDILL, Alphoretta, Ky.
Death Date: 11 January 1938
Cause of Death: Acute cardiac failure
Contributory: Cardiac collapse following
anesthetic for tonsillectomy
Signed: Philip Bress, M.D., Lackey, Ky.
Burial Place: Alphoretta, Ky.
Date of Burial: 03 January 1938
Undertaker: G. D. Ryan, Martin, Ky.
File Date: 16 August 1938
Registrar: G. C. Collins, D.D.S.
Transcribed by Debbie Tamborski, 11 October 2009 |
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