|
DEATH
CERTIFICATE
JOE COMBS
Date 07 November 1940
Cert: 05765
Place of Death: County: Perry City or Town:
Rural
Name of Hospital or Institution: Scuddy, Ky.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Perry
City or Town: Rural Street No.:
#41
Full Name: Joe COMBS
If Veteran Name War: (blank)
Social Security No.: 402-01-6359
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Orlena COMBS
Age of husband or wife if alive: 42 years
Birth date of deceased: (blank)
Age: 53 years
Birthplace: Knott Co., Ky.
Occupation: Coal Miner
Industry or business: (blank)
Father Name: John COMBS
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Dulcenia SMITH
Mother Birthplace: Knott Co., Ky.
Informant: Earl COMBS, Scuddy, Ky.
Burial Place: Burial - Irishman Creek
Date: 08 November 1940
Signature of funeral director: Engle Und. &
Hdwe. Co., Hazard, Ky.
Date received by local registrar: 19 February 1941
Registrar's Signature: Kathryn S. Johnson
Date of Death: 07 November 1940
I hereby certify that I attended deceased from 07 November
1940 to
07 November 1940, that I last saw him alive on 07 November
1940, and that death occurred on the date stated above at 2
p.m.
Immediate cause of death: Hypertensive Cardiovascular Heart
Disease
Duration:
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: C. L. Combs, M.D., Kodak, Ky.
Date signed: 17 February 1941
Transcribed by Debbie Tamborski, 08 May 2010 |
|