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DEATH
CERTIFICATE
POLLY COMBS
Date 11 December 1930
Cert: 31884
Place of Death: Voting Pct: Hurst & Snyder Hosp. RR#8,
Hazard, Perry Co., Ky.
Full Name: Polly COMBS
Residence: (?Carr fork?)
Length of Residence in city where death occurred:
(blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Letcher COMBS
Date of Birth: (blank)
Age: 32 years, 02 months, 27 days
Occupation: Housewife Total time
spent in this occupation: 06 years
Birthplace: Knott Co.
Father Name: James SMITH
Birthplace Father: Knott Co.
Mother Maiden Name: Elizabeth SMITH
Birthplace Mother: Knott Co.
Informant/Address: Letcher COMBS
Burial Cremation Removal Place: Talcum
Date: 13 December 1930
Undertaker/Address: Hazard Hardware
Filed: 31 December 1930
Registrar: J. P. Boggs
Death of Date: 11 December 1930
I hereby certify, That I attended deceased from (blank) to
(blank), that I last saw her alive on 10 December 1930, death
is said to have occurred on the date stated above, at 1 a.m.
Cause of Death: Post Partum Eclampsia
Date of onset: (blank)
Contributory causes: (blank)
Name of operation: (blank)
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Specify where injury occurred: (blank)
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: (blank)
Signed/Address: Taylor Hurst, M.D., Hazard, Ky.
Transcribed by Debbie Tamborski, 28 March 2010 |
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