|
DEATH
CERTIFICATE
DOLPH COMBS
Date 17 October 1946
Cert: Original #23583
Place of Death: County: Floyd City or
Town: Wayland
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Raven
Full Name: Dolph COMBS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Lue COMBS
Age of husband or wife if alive: 54
Birth date of deceased: 10 August
Age: 57 years
Birthplace: Knott Co.
Occupation: (blank)
Industry or business: (blank)
Father Name: K. F. COMBS
Father Birthplace: Knott Co.
Mother Maiden Name: Nannie GIBSON
Mother Birthplace: Knott
Informant: Lou COMBS, Raven, Ky.
Burial Place: Wayland, Ky.
Date: 19 October 1946
Signature of funeral director: G. D. Ryan, Jr., Martin,
Ky.
Date received by local registrar: 29 November 1946
Registrar's Signature: Lucy Ramsdell
Date of Death: 17 October 1946
I hereby certify that I attended deceased from (blank) to
(blank), that I
last saw him alive on (blank), and that death occurred on the date
stated above at 11:00 p.m.
Immediate cause of death: Fractured cervical (illegible)
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: accident
Date of occurrence: 17 October 1946
Where did injury occur: Coal mine
While at work: yes
Means of injury: Slate Fall
Signature: W. J. Ryan, Martin, Ky.
Date signed: 24 November 1946
Transcribed by Debbie Tamborski, 10 February 2010 |
|