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DEATH
CERTIFICATE
BRENDA COMBS
Date 22 June 1952
Cert: 19880
Place of Death: County: Perry City or Town:
Ary
Length of stay in hospital or community: (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Kentucky County: Knott
City or Town: Tina
Full Name: Brenda COMBS
Date of Death: 22 June 1952
Sex, Color/Race, Marital Status: Female, White, Never married
Date of Birth: (blank)
Age: 03 years
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Kentucky
Father's Name: Shiloh COMBS, Jr.
Mother's Maiden Name: Daphine GRIGSBY
Was deceased ever in armed forces: No
Social Security No.: No
Informant: (blank)
Disease or condition directly leading to death: Crush
injury of chest, internal hemorrhage
Interval between onset and death: (blank)
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings for operation: (blank)
Accident, suicide, or homicide: accident
Place of injury: highway
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: Automobile wheel ran over her
I hereby certify that I attended deceased from 22 June 1952 to
22 June 1952, that I
last saw the deceased alive on 22 June 1952, and that death occurred on
the date stated above at 10:30 p.m., from the causes and on the date
stated above.
Date signed: 22 June 1952
Address: Ary, Perry Co., Ky.
Signature: K. W. Cameron, MB ChB
Burial, Cremation or Removal: Burial
Date: 24 June 1952
Name of Cemetery or Creamatory: Family
Location: Knott Co., Ky.
Date received by local registrar: 24 June 1952
Registrar's Signature: Georgia P. Surer
Funeral director and address: None
Transcribed by Debbie Tamborski, 20 February 2010 |
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