Date: 07 January 1950
Cert: 01124
Place of Death: County: Knott
City or Town: Rural
Length of stay (in this place): All of life
Street address or location: Carrie, Ky.
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural If rural
give precinct: Carrie, Ky.
Full Name: America CLEMONS
Date of Death: 07 January 1950
Sex, Color or Race, Marital Status: Female, White, Widowed
Date of Birth: 04 April 1866
Age: 83 years
Usual Occupation: Housekeeper
Kind of Industry or business: Keeping house
Birthplace: Knott Co., Ky.
Father's Name: Charlie FUGATE
Mother's Maiden Name: Nancy HUDSON
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Charlie CLEMONS
Disease or condition directly leading to death: (blank)
Interval between onset and death: (blank)
Due to: (blank)
Other significant conditions: Heart Condition this person was
found dead in a field. After talking with the Dr. when
had cared for her The Coroner jury, gave heart condition.
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
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 at 7 p.m., from the causes and on the
date stated above. 07 January 1950
Date signed: 10 January 1950
Address: Hindman, Ky.
Signature: J. N. Taul, Coroner
Burial, Cremation or Removal: Burial
Date: 11 Janaury 1950
Name of Cemetery or Crematory: Family
Location: Carrie, Ky.
Date received by local registrar: 18 January 1950
Registrar's Signature: Rose B. Craft
Funeral director/address: Hindman Funeral Home, Hindman, Ky.
Transcribed by Debbie Tamborski, 12 January 2011 |