|
DEATH
CERTIFICATE
POLLIE ANNN
COLLINS
Date: 23 February 1950
Cert: 13939
Place of Death: County: Floyd City or Town:
Bevinsville
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Kentucky County:
Floyd
City or Town: Bevinsville Street Address: (blank)
Full Name: Pollie Annn COLLINS
Date of Death: 23 February 1950
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 21 May 1893
Age: 77 years (transcribed as written)
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Knott County
Father's Name: Buddie TRIPTLETT
Mother's Maiden Name: Jance (?HUBBISS? illegible)
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: (blank)
Disease or condition directly leading to death: Probably
heart attack found dead in bed
Interval between onset and death: (blank)
Due to:
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw the deceased alive on (blank), and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: 19 June 1950
Address: Prestonsburg, Ky.
Signature: Marvin Ransdell, M.D.
Burial, Cremation or Removal: (blank)
Date: 25 February 1950
Name of Cemetery or Crematory: Family Cemetery
Location: Bevinsville, Kentucky
Date received by local registrar: 19 June 1950
Registrar's Signature: Lucy Ransdell
Funeral director/address: E. P. Arnold, Prestonsburg,
Kentucky
Transcribed by Debbie Tamborski, 14 July 2010 |
|