|
DEATH
CERTIFICATE
EMMIT COLLINS
Date 09 October 1939
Cert: 27974
Name: Emmit COLLINS
Place of Death: Knott Co., Lackey, Stumbo Memorial Hospital
Residence: Floyd Co., Wheelwright, Ky.
Male, White, Single
Husband or Wife of: (blank)
Birth Date: 20 November 1919
Age: 20 years, 10 months, 19 days
Occupation: (blank)
Place of Birth: Ohio
Name of Father: Isac N. COLLINS
Birthplace Father: Johnson Co.
Maiden Name of Mother: Rosie G. BALL
Birthplace Mother: Pineville, Ky.
Informant: Alvin LITTLE, Wheelwright
Death Date: 09 October 1939
Cause of Death: Peritonitis due to gunshot wound
Signed: C. B. Ison, M.D., Lackey, Ky. 13 October
1939
Burial Place: Davis Point
Date of Burial: 11 October 1939
Undertaker: G. D. Ryan, Martin, Ky.
File Date: (blank)
Registrar: (blank)
Transcribed by Debbie Tamborski, 11 November 2009 |
|