Date: 03 December 1942
Cert: 09346
Place of Death: County: Knott City or
Town: Soft Shell
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: (blank)
Full Name: Russell CONLEY
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Eva CONLEY
Age of husband or wife if alive: 24 years
Birth date of deceased: 19 December 1910
Age: 32 years
Birthplace: Knott Co., Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: David CONLEY
Father Birthplace: Knott Co.
Mother Maiden Name: Margaret RAMEY
Mother Birthplace: Knott Co.
Informant: Troy CONLEY, Soft Shell
Burial Place: Ramey Cemetery
Date: December 1943 (transcribed as written)
Signature of funeral director: Lee Gayheart, Soft Shell
Date received by local registrar: 15 March 1943
Registrar's Signature: Ida Livingston
Date of Death: 03 December 1942
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 (blank)
Immediate cause of death: Pulmonary T. B.
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: J. W. Duke, M.D., Hindman
Date signed: (illegible)
Transcribed by Debbie Tamborski, 17 October 2010 |