Date: 13 September 1945
Cert: 19577
Place of Death: County: Knott City or
Town: Hindman
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Leburn
Full Name: Leona CLICK
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Lee CLICK
Age of husband or wife if alive: 36 years
Birth date of deceased: 10 June 1909
Age: 36 years, 03 months, 03 days
Birthplace: Knott Co., Ky.
Occupation: Domestic
Industry or business: (blank)
Father Name: Green COMBS
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Sissy STAMPER
Mother Birthplace: Knott Co., Ky.
Informant: Lee CLICK, Leburn, Ky.
Burial Place: Leburn, Ky.
Date: 15 September 1945
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: 28 September 1945
Registrar's Signature: Rose B. Craft
Date of Death: 13 September 1945
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at 5:00 p.m.
Immediate cause of death: Brain Injury
Duration: (blank)
Due to: Skull Fracture
Major findings of operations: (blank)
Accident, suicide, or homicide: accident
Date of occurrence: 13 September 1945
Where did injury occur: State Highway
While at work: No
Means of injury: Auto
Signature & Address: W. J. Ryan, Embalmer, Martin,
Ky.
Date signed: 15 September 1945
Transcribed by Debbie Tamborski, 26 November 2010 |