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DEATH
CERTIFICATE
ROBERT COMBS
Date 25 June 1933
Cert: 14947
Place of Death: Voting Pct. No. 25, Hazard Hospital, Hazard,
Perry Co., Ky.
Full Name: Robert COMBS
Residence: Sassafras, Ky.
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Rosa Lee COMBS
Date of Birth: 01 January 1904
Age: 29 years, 05 months, 24 days
Occupation: Loaded coal, coal miner, 08 years
Birthplace: Fisty, Ky.
Father Name: Silas COMBS
Birthplace Father: Ky.
Mother Maiden Name: Rachel RITCHIE
Birthplace Mother: Ky.
Informant/Address: Brax COMBS, Sassafras, Ky.
Burial Cremation Removal Place: Burial - Sassafras, Ky.
Date: 27 June 1933
Undertaker/Address: Willard K. Williams, Hazard, Ky.
Filed: 27 June 1933
Registrar: J. P. Boggs
Death of Date: 25 June 1933
I hereby certify, That I attended deceased from 25 Juen 1933 to
25 June 1933, that I last saw him alive on 25 June 1933, death
is said to have occurred on the date stated above, at 7:20
Cause of Death: Crushed chest & fracture of skull
Date of onset: 25 June 1933
Contributory causes: automobile accident
Name of operation: None
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: J. E. Hagan, Hazard, Ky.
Transcribed by Debbie Tamborski, 01 April 2010 |
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