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DEATH
CERTIFICATE
JEWEL COLLINS
Date 30 July 1945
Cert: 15746
Place of Death: County: Perry Co. City or
Town: Hazard, Ky.
Name of Hospital or Institution: Hazard Hospital Co.
Length of stay in hospital or community: 10 days
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Sasfrass, Ky.
Full Name: Jewel COLLINS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Widowed
Husband or Wife of: Deceased
Age of husband or wife if alive: (blank)
Birth date of deceased: (blank)
Age: 30 years
Birthplace: Alb.
Occupation: House Wife
Industry or business: (blank)
Father Name: Hubbert MULLINS
Father Birthplace: Alb.
Mother Maiden Name: Ida MUNNIE
Mother Birthplace: Alb.
Informant: Hubbert MULLINS, Sasfrass, Ky.
Burial Place: Black Gold
Date: 31 July 1945
Signature funeral director: Maggard Funeral Home, Hazard, Ky.
Date received by local registrar: 30 July 1945
Registrar's Signature: Opsie J. Deaton
Date of Death: 30 July 1945
I hereby certify that I attended deceased from 22 July 1945 to
30 July 1945, that I
last saw him alive on 30 July 1945, and that death occurred on the date
stated above at 10:15 p.m.
Immediate cause of death: Coronary Embolism
Due to: 7th day post-operation of (illegible)
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: 30 July 1945
Transcribed by Debbie Tamborski, 09 February 2010 |
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