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DEATH
CERTIFICATE
MELVINA COMBS
Date 26 June 1935
Cert: 14652
Place of Death: Voting Pct.: Anchorage, Lakeland,
Jefferson Co., Ky.
Full Name: Melvina COMBS (committed from Jefferson
County, Kentucky)
Residence: Central State Hospital, Lakeland, Kentucky
Length of Residence: 02 years, 02 months, 18 days
Sex, Color or Race, Marital Status: Female, White,
Single
Husband or Wife of: (blank)
Date of Birth: 06 June 1908
Age: 27 years, 00 months, 20 days
Occupation: (blank)
Birthplace: Knott County, Kentucky
Father Name: Unknown
Birthplace Father:
"
Mother Maiden Name: "
Birthplace Mother: "
Informant/Address: Records - Central State Hospital,
Lakeland, Kentucky
Burial Cremation Removal Place: Lakeland
Date: 28 June 1935 03 July 1935
Undertaker/Address: Central State Hospt., Lakeland, Ky.
Filed: 26 June 1935
Registrar: Mr. A. Hawkins, Deputy (illegible) Ferguson
Death of Date: 26 June 1935
I hereby certify, That I attended deceased from 19 August 1933 to
26 June 1935, that I last saw her alive on 26 June 1935, death
is said to have occurred on the date stated above, at 12:00
noon
Cause of Death: Pulmonary Tuberculosis
Date of onset: (blank)
Contributory causes: (blank)
Name of operation: (blank)
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: (blank)
Signed/Address: Roy E. Bingham, M.D., Lakeland, Kentucky
Transcribed by Debbie Tamborski, 16 April 2010 |
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