Date: 29 January 1945
Cert: 06255
Place of Death: County: Knott City or
Town: Topmost
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: Topmost
Full Name: Martha COOK
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Widowed
Husband or Wife of: Enon COOK
Age of husband or wife if alive: (blank)
Birth date of deceased: 14 November 1868
Age: 76 years, 02 months, 15 days
Birthplace: Floyd Co., Ky.
Occupation: Domestic
Industry or business: (blank)
Father Name: Hi MULLINS
Father Birthplace: Floyd Co., Ky.
Mother Maiden Name: Elizabeth HAMILTON
Mother Birthplace: Floyd Co., Ky.
Informant: Wm. A. COOK, Topmost, Ky.
Burial Place: Topmost, Ky.
Date: 30 January 1945
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: 29 March 1945
Registrar's Signature: Rose B. Craft
Date of Death: 29 January 1945
I hereby certify that I attended deceased from 01 January 1945 to
23 January 1945, that I last saw him alive on 23 January 1945,
and that death occurred on the date stated above at 11:35 p.m.
Immediate cause of death: Lobar Pneumonia
Duration: 01 week
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: 28 March 1945
Transcribed by Debbie Tamborski, 27 November 2010 |