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DEATH
CERTIFICATE
JASPER COMBS
Date 19 December 1919
Cert: Original #18749 Duplicate
#9586
Place of Death: Voting Precinct: No. 10, Hazard, Perry Co.,
Ky.
Full Name: Jasper COMBS
Sex, Color or Race, Marital Status: Male, White, Single
Date of Birth: 21 August 1891
Age: 28 years, 03 months, 28 days
Occupation: Farming
Birthplace: Knott Co., Ky.
Name of Father: John S. COMBS
Birthplace Father: Perry Co., Ky.
Maiden name of Mother: (illegible) GAYHEART
Birthplace Mother: Knott Co., Ky.
Informant/Address: Sherman HOLLIDAY, (illegible)
Filed: 17 July 1926
Registrar: J. P. Boggs
Death Date: 19 December 1919
I hereby certify that I attended deceased from 17 December
1919, to
19 December 1919, that I last saw him alive on 19 December
1919, and that death
occurred, on the date stated above, at (blank)
Cause of Death: Gun shot wound in abdomen
Duration: 02 days
Contributory: Homicidal
Signed/Address: (illegible), M.D., 20 December 1919,
Hazard
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: Vest, Ky.
Date of Burial: 21 December 1919
Undertaker/Address: G. W. Nicholson, Hazard, Ky.
Transcribed by Debbie Tamborski, 21 March 2010 |
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