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DEATH
CERTIFICATE
JAMES FRANKLIN COOK
Date 23 June 1940
Cert: 15190
Place of Death: County: Knott Co. City or Town:
Lackey
Name of Hospital or Institution: Stumbo Memorial Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Topmost, Ky.
Full Name: James Franklin COOK
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: 22 February 1924
Age: 16 years, 04 months, 01 days
Birthplace: Knott Co., Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Albert COOK
Father Birthplace: Knott Co.
Mother Maiden Name: Cora OSBORN
Mother Birthplace: Floyd Co., Ky.
Informant/Address: Albert COOK, Topmost, Ky.
Burial Place: Topmost, Ky.
Date: 24 June 1940
Signature of funeral director/address: G. D. Ryan, Martin, Ky.
Date received by local registrar: 28 June 1940
Registrar's Signature: Macie Miller
Date of Death: 23 June 1940
I hereby certify that I attended deceased from 23 June 1940 to
23 June 1940, that I last saw him alive on 23 June 1940, and
that death occurred on the date stated above at 10:00 p.m.
Immediate cause of death: Third degree burns about the
upper extremities
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. L. Stumbo, M.D., Martin, Ky.
Date signed: 25 June 1940
Transcribed by Debbie Tamborski, 17 August 2010 |
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