Date: 12 September 1944
Cert: 20722
Place of Death: County: Knott City or
Town: Sassafras
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: Sassafras
Full Name: Albert W. CAULDILL
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: 07 December 1942
Age: 01 years, 10 months, 05 days
Birthplace: Knott Co., Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Riley CAUDILL
Father Birthplace: Ky.
Mother Maiden Name: Lillian HOLLIMAN
Mother Birthplace: Ky.
Informant: Riley CAUDILL, Sassafras, Ky.
Burial Place: Red Fox, Ky.
Date: 13 September 1944
Signature of funeral director: Engles, Hazard, Ky.
Date received by local registrar: 16 September 1944
Registrar's Signature: Ida Livingston Rose
B. Craft Acting registrar
Date of Death: 12 September 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 1:30 p.m.
Immediate cause of death: Diphtheria Pharyngeal
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: J. R. Aker, M.D., Anco, Ky.
Date signed: 14 September 1944
Transcribed by Debbie Tamborski, 08 November 2010 |