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DEATH
CERTIFICATE
MARTHA COBERN
Date 26 September 1941
Cert: 23969
Place of Death: County: Floyd City or Town:
Martin
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County: Floyd
City or Town: Martin, Ky.
Full Name: Martha COBERN
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 06 December 1864
Age: 77 years, 09 months, 20 days
Birthplace: Knott Co.
Occupation: Invalid
Industry or business: (blank)
Father Name: W. O. COBERN
Father Birthplace: Knott Co.
Mother Maiden Name: Polly HANDSHOE
Mother Birthplace: Knott
Informant: John COBERN, Martin, Ky.
Burial Place: Minnie, Ky.
Date: 27 September 1941
Signature of funeral director: O. T. Leemaster, Martin
Date received by local registrar: 11 October 1941
Registrar's Signature: Mrs. Ben Norris
Date of Death: 26 September 1941
I hereby certify that I attended deceased from 06 December
1864 to
26 September 1941, that I last saw her alive on 13 September
1941, and that death occurred on the date stated above at 9:45
p.m.
Immediate cause of death: Invalid all her life. No
Doctor
Duration: (blank)
Due to: Cripple
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: O. T. Leemaster, F.D., Martin,
Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 12 May 2010 |
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