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DEATH
CERTIFICATE
ANDREW COMBS
Date: 15 May 1947
Cert: 10321
Place of Death: County: Breathitt City or Town:
Jackson
Street No. or Location: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky County: Breathitt
City or Town: Jackson
Full Name: Andrew COMBS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Margaret COMBS
Age of husband or wife if alive: 67 years
Birth date of deceased: 03 November 1871
Age: 75 years, 06 months, 12 days
Birthplace: Knott Co.
Occupation: U. S. Marshall
Industry or business: (blank)
Father Name: Sim COMBS
Father Birthplace: Ky.
Mother Maiden Name: Abbie GAYHEART
Mother Birthplace: Ky.
Informant: Hillard COMBS, Jackson, Ky.
Burial Place: (blank)
Date: 17 May 1947
Signature of funeral director: Ray & Blake, Jackson, Ky.
Date received by local registrar: 19 May 1947
Registrar's Signature: Gladys Deaton
Date of Death: 15 May 1947
I hereby certify that I attended deceased from 07 May 1947 to
15 May 1947, that I last saw him alive on 15 May 1947, and
that death occurred on the date stated above at 11:45 p.m.
Immediate cause of death: Hypertension
Duration: (blank)
Due to: (blank)
Other conditions: Hypertensive heart disease
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: Price Sewell, Jr., M.D.,
Jackson, Ky.
Date signed: 23 May 1947
Transcribed by Debbie Tamborski, 22 June 2010 |
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