Date: 27 November 1943
Cert: 09966
Place of Death: County: Knott City or
Town: Sassafras, Ky.
Street No. or Location: Rural
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Sassafras, Ky.
Rural
Full Name: Paul Truman 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: 20 April 1937
Age: 06 years, 07 months, 07 days
Birthplace: Amburgey, Ky.
Occupation: School boy
Industry or business: (blank)
Father Name: Willie COOK
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Corna OWENS
Mother Birthplace: (blank)
Informant: Mamie REYNOLDS, Pinetop, Ky.
Burial Place: Cornett Hill
Date: 28 November 1943
Signature of funeral director: Family & Neighbors, Sassafras,
Ky.
Date received by local registrar: 21 February 1944
Registrar's Signature: Ida Livingston
Date of Death: 27 November 1943
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: Accidental truck on highway ran over
him. I did not see this child but all reports indicate
that he was killed instantly.
Duration: (blank)
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: Accident
Date of occurrence: (blank)
Where did injury occur: On highway in Sassafras
While at work: (blank)
Means of injury: (blank)
Signature & Address: (blank), Hindman, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 23 October 2010 |