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DEATH
CERTIFICATE
ROBERT L. COLLINS
Date 06 February 1939
Cert: 08399
Name: Robert L. COLLINS
Place of Death: Voting Pct. Hazard Hospital Co., Hazard, Perry
Co., KY
Residence: Ivan, Ky.
Length of residence: (blank)
Male, White, Married
Husband or Wife of: (blank)
Birth Date: 13 June
Age: 35 years
Occupation: (blank)
Place of Birth: Knott Co., Ky.
Name of Father: Valentine COLLINS
Birthplace Father: Tennessee
Maiden Name of Mother: Una AMBURGEY
Birthplace Mother: Knott Co., Ky.
Informant: Valentine (illegible), Litt Carr, Ky.
Burial Cremation Removal Place: Litt Carr, Ky.
Date: (blank)
Undertaker/Address: (blank) Whitesburg, Ky.
Filed: 27 March 1939
Registrar: Virginia Combs
Death of Date: 06 Feburary 1939
I hereby certify, That I attended deceased from 11 January
1939 to 06 February 1939, that I last saw him alive on 06
February 1939, death is said to have occurred on the date
stated above, at 12 noon
Cause of Death: 1. Encephalitis 2. Bronchial pneumonia
unresolved
Date of onset: (blank)
Contributory causes: Infected Tonsils and sinuses
Name of operation: None Was there an
autopsy: No
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: No
Signed/Address: J. E. Hagan, M.D. Hazard, Ky.
Transcribed by Debbie Tamborski, 03 May 2010 |
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