Date: 13 November 1946
Cert: 24395
Place of Death: County: Knott City or
Town: Lackey
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Lackey, Ky.
Full Name: Shade COMBS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White
Husband or Wife of: Alice TUCKER
Age of husband or wife if alive: 40 years
Birth date of deceased: 13 November 1882
Age: 64 years
Birthplace: Pine Top, Ky.
Occupation: Ky. West Gass Co.
Industry or business: Gass
Father Name: Quin COMBS
Father Birthplace: Pine Top
Mother Maiden Name: Polly FRANKLIN
Mother Birthplace: Pine Top, Ky.
Informant: Pearl COMBS, Leburn, Ky.
Burial Place: Leburn, Ky.
Date: 15 November 1946
Signature of funeral director: G. D. Ryan, Martin, Ky.
Date received by local registrar: 18 November 1946
Registrar's Signature: Mrs. Rose B. Craft
Date of Death: 18 November 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 10:00 a.m.
Immediate cause of death: Cerebral Hemorrhage
Duration: (blank)
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: W. J. Ryan, Emb., Martin, Ky.
Date signed: 14 November 1946
Transcribed by Debbie Tamborski, 04 December 2010 |