Date: 01 February 1947
Cert: 6623
Place of Death: County: Knott City or
Town: Handshoe, Ky. Rural
Street Number or Location: At own home
Length of stay in hospital or community: 01 months, 12 days
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Handshoe, Ky. - Rural
Full Name: Herman CONLEY
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White,
Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 20 December 1946
Age: 01 months, 12 days
Birthplace: Handshoe, Ky., Floyd Co.
Occupation: (blank)
Industry or business: (blank)
Father Name: Golden CONLEY
Father Birthplace: Handshoe, Ky.
Mother Maiden Name: Mae HANDSHOE
Mother Birthplace: Handshoe, Ky., Knott Co.
Informant: Golden CONLEY, Handshoe
Burial Place: Handshoe, Ky.
Date: 02 February 1947
Signature of funeral director: (blank)
Date received by local registrar: 16 March 1947
Registrar's Signature: Rose B. Craft
Date of Death: 01 February 1947
I hereby certify that I attended deceased from 01 February
1947 to
01 February 1947, that I last saw him alive on 01 February
1947, and that death
occurred on the date stated above at 7 p.m.
Immediate cause of death: Broncho Pneumonia
Duration: 04 days
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: Mark Dempsey, M.D., Garrett,
Ky.
Date signed: 11 February 1947
Transcribed by Debbie Tamborski, 16 December 2010 |