Date: 05 June 1947
Cert: 22629
Place of Death: County: Knott City or
Town: Lackey, Ky. Rural
Name of Hospital or Institution: Stumbo Memo.
Length of stay in hospital or community: 02 Days
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Topmost Rural
Full Name: Bertha COMBS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Single
Husband or Wife of: (blank)
Age of husband or wife if alive: 45 years (transcribed as
written)
Birth date of deceased: 19 August 1923
Age: 23 years, 09 months, 16 days
Birthplace: Topmost, Ky.
Occupation: Domestic
Industry or business: (blank)
Father Name: Mont COMBS
Father Birthplace: Mousie
Mother Maiden Name: Canzella HALL
Mother Birthplace: Topmost, Ky.
Informant: Mont COMBS, Topmost, Ky.
Burial Place: Topmost
Date: 07 June 1947
Signature of funeral director: G. D. Ryan, Martin
Date received by local registrar: 09 October 1947
Registrar's Signature: Rose B. Craft
Date of Death: 05 June 1947
I hereby certify that I attended deceased from 03 June 1947 to
05 June 1947, that I last saw him alive on 05 June 1947, and
that death occurred on the date stated above at 7:30 a.m.
Immediate cause of death: Cardiac failure
Duration: (blank)
Due to: Coronary thrombosis
Major findings of operations: Death followed operation for
salpingitis
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: C. M. Aker, M.D., Lackey, Ky.
Date signed: 08 October 1947
Transcribed by Debbie Tamborski, 16 December 2010 |