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DEATH
CERTIFICATE
JAMES COMBS
Date: 23 January 1950
Cert: 01779
Place of Death: County: Breathitt City or Town:
Rural-Jackson
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky. County:
Breathitt
City or Town: Rural Street Address: (blank)
Full Name: James COMBS
Date of Death: 23 January 1950
Sex, Color or Race, Marital Status: Male, Colored, Married
Date of Birth: 20 June 1882
Age: 67 years
Usual Occupation: Farmer
Kind of Industry or business: (blank)
Birthplace: Knott Co., Ky.
Father's Name: John COMBS
Mother's Maiden Name: Louisa FRANCIS
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Casa COMBS
Disease or condition directly leading to death: Pulmonary
Tuberculosis
Interval between onset and death: 13 months
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw the deceased alive on (blank), and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: 01 March 1950
Address: Jackson, Ky.
Signature: Price Sewell, Jr., M.D.
Burial, Cremation or Removal: Burial
Date: (blank)
Name of Cemetery or Crematory: Cooy Cem.
Location: Cooy, Ky.
Date received by local registrar: 26 January 1950
Registrar's Signature: Gladys H. Deaton
Funeral director & address: (blank)
Transcribed by Debbie Tamborski, 14 July 2010 |
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