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DEATH
CERTIFICATE
RAYMOND CAUDILL
Date 05 December 1942
Cert: 02290
Place of Death: County: Perry City or Town:
Hazard
Name of Hospital or Institution: Hazard Hospital Co.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Red Fox
Full Name: Raymond 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: 06 January 1935
Age: 07 years
Birthplace: Knott Co., Ky.
Occupation: Student
Industry or business: (blank)
Father Name: Riley CAUDILL
Father Birthplace: Letcher Co., Ky.
Mother Maiden Name: Lillian HOLLIMAN
Mother Birthplace: Ky.
Informant: Riley CAUDILL, Red Fox, Ky.
Burial Place: Red Fox, Ky.
Date: 06 December 1942
Signature funeral director: Engle Und. & Hdw. Co., Hazard, Ky.
Date received by local registrar: 01 January 1943
Registrar's Signature: (illegible)
Date of Death: 05 December 1942
I hereby certify that I attended deceased from 05 December
1942 to 05 December 1942, that I
last saw him alive on 05 December 1942, and that death occurred on the date
stated above at 2:25 p.m.
Immediate cause of death: Fractured skull with
(illegible) hemorrhage
Due to: Gunshot wound of head
Major findings of operations: (blank)
Accident, suicide, or homicide: Accident
Date of occurrence: 06 December 1942
Where did injury occur: at home shot with 22 gauge gun
While at work: No
Means of injury: (blank)
Signature: Chris S. Jackson, M.D., Hazard, Ky.
Date signed: 18 December 1942
Transcribed by Debbie Tamborski, 02 February 2010 |
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