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DEATH
CERTIFICATE
Miss MARTHA CLAY
Date 12 August 1926
Cert: 20642
Place of Death: Voting Precinct: Hazelwood Sanitarium,
Louisville, Jefferson Co., Ky.
Full Name: Miss Martha CLAY
Sex, Color or Race, Marital Status: Female, White, Single
Date of Birth: 26 September 1903
Age: 22 years, 10 months, 16 days
Occupation: Housework
Birthplace: Knott Co., Ky.
Name of Father: Milt CLAY
Birthplace Father: West Virginia
Maiden name of Mother: Racheal FUGATE
Birthplace Mother: Kentucky
Informant/Address: Hospital Record, Louisville, Ky.
Filed: 20 August 1926
Registrar: Dr. (illegible)
Death Date: 12 August 1926
I hereby certify that I attended deceased from 03 July 1926,
to 12 August 1926, that I last saw her alive on 12 August
1926, and that death occurred, on the date stated above, at
1:10 a.m.
Cause of Death: Tuberculosis, Pulmonary Chronic
Duration: 01 years
Contributory: (blank)
Signed/Address: Paul A. Turner, M.D.,
Hazelwood, Louisville, Ky.
Length of residence at place of death: 01 month, 09 days
Length of residence in the State: 22 years, 10 months, 16 days
Where was disease contracted if not at place of death:
Hardburly, Ky.
Former or usual residence: Hardburly, Ky.
Place of Burial or Removal: Body turned over to
(illegible)
Date of Burial: 16 August 1926
Undertaker/Address: John W. Manning, City
Transcribed by Debbie Tamborski, 21 March 2010 |
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