|
DEATH
CERTIFICATE
RACEL COMBS
Date: 09 January 1946
Cert: 02448
Place of Death: County: Perry City or Town:
Acup
Street No. or Location: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Perry
City or Town: Rural If
rural give precinct: Acup
Full Name: Racel COMBS
If Veteran Name War: (blank)
Social Security No.: 403-22-7201
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: Sampson B. COMBS
Age of husband or wife if alive: 82 years
Birth date of deceased: 25 October 1861
Age: (blank)
Birthplace: Knott Co., Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Robert CORNETT
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Adaline BRASHER
Mother Birthplace: Perry Co., Ky.
Informant: Luther COMBS, Vicco, Ky.
Burial Place: Combs
Date: 10 January 1946
Signature of funeral director: Maggard, Hazard, Ky.
Date received by local registrar: 11 January 1946
Registrar's Signature: Opsie J. Deaton
Date of Death: 09 January 1946
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at 12 a.m.
Immediate cause of death: Arteriosclerosis
Duration: (blank)
Due to: Senility
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., Hazard, Ky.
Date signed: 10 January 1945 (transcribed as written)
Transcribed by Debbie Tamborski, 07 June 2010 |
|