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DEATH
CERTIFICATE
DELILAH COLLINS
Date: 20 July 1946
Cert: 14499
Place of Death: County: Breathitt City or Town:
Rural Elkatawa
Street No. or Location: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Breathitt
City or Town: Rural
Full Name: Delilah COLLINS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Widowed
Husband or Wife of: Levi COLLINS
Age of husband or wife if alive: (blank)
Birth date of deceased: 29 July
Age: 85 years
Birthplace: Knott Co.
Occupation: At Home
Industry or business: (blank)
Father Name: Wes FRANCIS
Father Birthplace: Ky.
Mother Maiden Name: Martha FUGATE
Mother Birthplace: Ky.
Informant: Cyrus COLLINS, Elkatawa, Ky.
Burial Place: (blank)
Date: 22 July 1946
Signature of funeral director: Ray & Blake, Jackson, Ky.
Date received by local registrar: 23 July 1946
Registrar's Signature: Gladys H. Deaton
Date of Death: 20 July 1946
I hereby certify that I attended deceased from 16 July 1946 to
20 July 1946, that I last saw him alive on (blank), and that
death occurred on the date stated above at 6:00 a.m.
Immediate cause of death: (?Perptri Lentuils Stuot? illegible)
Duration: (blank)
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 & Address: Joseph L. Patton, M.D.,
(illegible)
Date signed: 05 August 1946
Transcribed by Debbie Tamborski, 07 June 2010 |
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