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DEATH
CERTIFICATE
BILL COLLINS
Date 10 August 1945
Cert: 17854
Place of Death: County: Perry Co. City or
Town: Hazard, Ky.
Name of Hospital or Institution: Hazard Hospital
Length of stay in hospital or community:
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Anco, Ky.
Full Name: Bill COLLINS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, (blank)
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 29 July 1945
Age: 00 years, 00 months, 13 days
Birthplace: Anco, Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Delsa COLLINS
Father Birthplace: Letcher Co.
Mother Maiden Name: Lind. ALLEN
Mother Birthplace: Jackson, Ky.
Informant: Eva COLLINS, Anco, Ky.
Burial Place: Brinkley, Knott Co.
Date: 12 August 1945
Signature of funeral director: Maggard, Hazard, Ky.
Date received by local registrar: 11 August 1945
Registrar's Signature: Opsie J. Deaton
Date of Death: 10 August 1945
I hereby certify that I attended deceased from 10 August 1945 to
10 August 1945, that I
last saw him alive on 10 August 1945, and that death occurred on the date
stated above at 12 p.m.
Immediate cause of death: Dysentery
Due to: (blank)
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: Chris S. Jackson, M.D., Hazard, Ky.
Date signed: 20 August 1945
Transcribed by Debbie Tamborski, 09 February 2010 |
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