Date: 16 July 1943
Cert: 04913
Place of Death: County: Knott City or
Town: Rural
Street No. or Location: Anco, Ky.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural
Full Name: Anderson COMBS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Polly Ann COMBS
Age of husband or wife if alive: 68 years
Birth date of deceased: 28 April 1870
Age: 73 years
Birthplace: Perry Co., Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Jack COMBS
Father Birthplace: Perry Co., Ky.
Mother Maiden Name: Mary YOUNG
Mother Birthplace: Ky.
Informant: Mrs. Anderson COMBS, Anco, Ky.
Burial Place: Anco, Ky.
Date: 18 July 1943
Signature of funeral director: Engle's, Hazard, Ky.
Date received by local registrar: (blank)
Registrar's Signature: (blank)
Date of Death: 16 July 1943
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Heart Failure
Duration: (blank)
Due to: Chronic Passive Congestion Angina Pectoris &
hypertension
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: J. R. Aker, M.D., Anco, Ky.
Date signed: 16 February 1944
Transcribed by Debbie Tamborski, 20 October 2010 |