|
DEATH
CERTIFICATE
DAYTON COMBS
Date 21 December 1934
Cert: 02016
Place of Death: Voting Pct.: Roxana, Letcher Co., Ky.
Full Name: Dayton COMBS
Residence: Roxana, Ky.
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Male, White, Child
Husband or Wife of: Child
Date of Birth: 29 September 1923
Age: 11 years, 02 months, 21 days
Occupation: Student
Birthplace: Knott Co., Ky.
Father Name: Andrew COMBS
Birthplace Father: Knott Co., Ky.
Mother Maiden Name: Polly MULLINS
Birthplace Mother: Knott Co., Ky.
Informant/Address: Mrs. Polly ELDRIDGE
(mother), Roxana, Ky.
Burial Cremation Removal Place: in Knott Co., Ky.
Date: 23 December 1934
Undertaker/Address: None--family, Roxana, Ky.
Filed: (blank)
Registrar: (blank)
Death of Date: 21 December 1934
I hereby certify, That I attended deceased from (blank) to
(blank), that I last saw h-- alive on 28 November 1934, death is said
to have occurred on the date stated above, at (blank)
Cause of Death: Tuberculosis Enteritis
Date of onset: 12 mo.
Contributory causes: Intestinal Parasites
Name of operation: None
Was there an autopsy: No
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: none
Nature of injury: none
Related to occupation: No
Signed/Address: R. H. Collins, M.D., Whitesburg, Ky.
Transcribed by Debbie Tamborski, 05 April 2010 |
|