Date: 03 April 1947
Cert: 11585
Place of Death: County: Knott City or
Town: Emmalena, Ky.
Street Number or Location: Rural
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Emmalena Street
No.: Rural
Full Name: Columbus COMBS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White,
Widowed
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: (blank)
Age: 68 years
Birthplace: Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Samuel COMBS
Father Birthplace: Ky.
Mother Maiden Name: Matilda YOUNG
Mother Birthplace: Ky.
Informant: M. F. KELLEY, Hindman, Ky.
Burial Place: Fisty Cemty.
Date: 04 April 1947
Signature of funeral director: Friends, Emmalena, Ky.
Date received by local registrar: 17 May 1947
Registrar's Signature: Rose B. Craft
Date of Death: 03 April 1947
I hereby certify that I attended deceased from 03 April 1947 to
04 April 1947, that I last saw him alive on 03 April1947, and
that death occurred on the date stated above at 9 p.m.
Immediate cause of death: Pneumonia caused by influenza
Duration: (blank)
Due to: (blank)
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: M. F. Kelley, Hindman, Ky.
Date signed: 01 May 1947
Transcribed by Debbie Tamborski, 16 December 2010 |