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DEATH
CERTIFICATE
ELIZA JANE CHRISTIAN
Date 29 September 1934
Cert: 26339
Place of Death: Voting Pct.: No. 30, Hazard Hospital,
Hazard, Perry Co., Ky.
Full Name: Eliza Jane CHRISTIAN
Residence: Sassafras
Length of Residence: life
Sex, Color or Race, Marital Status: Female, Colored,
Single
Husband or Wife of: (blank)
Date of Birth: 29 January 1883
Age: 51 years, 09 months
Occupation: House Keeper
Birthplace: Sassafras, Ky.
Father Name: Sam CHRISTIAN
Birthplace Father: Knott Co., Ky.
Mother Maiden Name: Do not know
Birthplace Mother:
" " "
Informant/Address: Monroe ADAMS, Sassafras, Ky.
Burial Cremation Removal Place: Sassafras, Ky.
Date: 01 October 1934
Undertaker/Address: H. Engle, Hazard, Ky.
Filed: 05 November 1934
Registrar: J. P. Boggs
Death of Date: 29 September 1934
I hereby certify, That I attended deceased from 28 September
1934 to 29 September 1934, that I last saw her alive on 29
September 1934, death is said
to have occurred on the date stated above, at 9:30 p.m.
Cause of Death: Myocarditis
Date of onset: (blank)
Contributory causes: Acute Cardiac dilalation
Name of operation: (blank)
What test confirmed diagnosis: Clinical
Was there an autopsy: No
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: (blank)
Signed/Address: J. E. Hagan, M.D., Hazard, Ky.
Transcribed by Debbie Tamborski, 04 April 2010 |
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