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DEATH
CERTIFICATE
LIZZIE HALL CHAFFINS
Date 16 April 1952
Cert: 06994
Place of Death: County: Fayette City or Town: Lexington
Length of stay in hospital or community:
Name of Hospital or Institution: Good Samaritan
Usual Residence of Deceased: State: Kentucky County: Knott
City or Town: Top Most, Ky.
Full Name: Lizzie HALL CHAFFINS
Date of Death: 16 April 1952
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: (blank)
Age: 43 years
Usual Occupation: House Keeper
Kind of Industry or business: (blank)
Birthplace: Kentucky
Father's Name: John HALL
Mother's Maiden Name: (blank)
Was deceased ever in armed forces: Yes, not in war
Social Security No.: (blank)
Informant: Hospital Records
Disease or condition directly leading to death: Heart attack
(?) (transcribed as written) arteriosclerosis
Interval between onset and death: 01 day
Due to: (blank)
Other significant conditions: Post op. gall bladder sy.
Interval between onset and death: 09 day
Date of Operation: (blank)
Major findings for operation: (blank)
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw the deceased alive on (blank), and
that death occurred on the date stated above at (blank), from
the causes and on the date stated above.
Date signed: 18 April
Address: Lexington 4, Ky.
Signature: (illegible) Daum, M.D.
Burial, Cremation or Removal: Burial
Date: 20 April 1952
Name of Cemetery or Creamatory: Family Cemetery
Location: Knott County, Ky.
Date received by local registrar: 21 April 1952
Registrar's Signature: D. A. Furlong
Funeral director/address: Hindman Funeral Home, Hindman, Ky.
Transcribed by Debbie Tamborski, 20 February 2010 |
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