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DEATH
CERTIFICATE
CURTIS COOK
Date: 29 January 1944
Cert: 00936
Place of Death: County: Floyd City or Town:
Martin
Hospital or Institution: Martin Gen. Hosp.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Floyd
City or Town: Halo
Full Name: Curtis COOK
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Melzina COOK
Age of husband or wife if alive: 15 years
Birth date of deceased: 28 February 1918
Age: 25 years, 11 months, 01 days
Birthplace: Knott Co., Ky.
Occupation: Coal Miner
Industry or business: (blank)
Father Name: Bill COOK
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Maggie HARRIS
Mother Birthplace: Knott Co., Ky.
Informant: Norma MARTIN, Halo, Ky.
Burial Place: Halo, Ky.
Date: 31 January 1944
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: 03 February 1944
Registrar's Signature: Winifred Norris
Date of Death: 29 January 1944
I hereby certify that I attended deceased from 18 January 1944 to
29 January 1944, that I last saw him alive on 29 January 1944,
and that death occurred on the date stated above at 4:00 p.m.
Immediate cause of death: Tetanus
Duration: (blank)
Due to: (Tetanus marked out) due to car wreck - knee
abrasions
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. Allen, M.D., Martin, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 02 June 2010 |
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