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DEATH
CERTIFICATE
JASPER COMBS
Date 19 December 1919
Cert: Duplicate #9586 Original #18749
Place of Death: Voting Precinct: Hazard Hospital (Broadway),
Hazard, Perry Co., Ky.
Full Name: Jasper COMBS
Sex, Color or Race, Marital Status: Male, White, Single
Date of Birth: August
Age: 27 years
Occupation: Miner
Birthplace: Vest, Knott Co.
Name of Father: John S. COMBS
Birthplace Father: Perry
Maiden name of Mother: Marinda GAYHEART
Birthplace Mother: Perry Co.
Informant/Address: Bell HOLLIDAY, Vest, Knott, Ky.
Filed: 05 May 1927
Registrar: J. P. Boggs
Death Date: 19 December 1919
I hereby certify that I attended deceased from 14 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: Gunshot wound of abdomen
Duration: (blank)
Contributory: (blank)
Signed/Address: R. L. Collins, M.D., 05 May 1927
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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