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DEATH
CERTIFICATE
SARAH CHAMBERS
Date: 26 March 1949
Cert: 09220
Place of Death: County: Floyd City or Town:
Wayland
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky. County:
Floyd
City or Town: Wayland Street Address:
(blank)
Full Name: Sarah CHAMBERS
Date of Death: 26 March 1949
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 1891
Age: 58 years
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Knott Co., Ky.
Father's Name: Tandy MCKINNEY
Mother's Maiden Name: Rebecca SPARKMAN
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Madge HICKS
Disease or condition directly leading to death:
Hypertension & Chronic Nephritis
Interval between onset and death: 02 years
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (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 1947 to
26 March 1949, that I last saw the deceased alive on 20 March
1949, and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: (blank)
Address: Wayland, Ky.
Signature: M. V. Wicker, M.D.
Burial, Cremation or Removal: Burial
Date: 26 March 1949
Name of Cemetery or Crematory: Slone Cemetery
Location: Dema, Ky.
Date received by local registrar: 12 May 1949
Registrar's Signature: Lucy Ransdell
Funeral director & address: C. R. Hatton, Martin,
Ky.
Transcribed by Debbie Tamborski, 12 July 2010 |
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