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DEATH
CERTIFICATE
JASPER CORNETT
Date 22 January 1930
Cert: 02311
Place of Death: Voting Precinct: Perry Co., Ky.
Full Name: Jasper CORNETT
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 28 May 1865
Age: 74 years, 08 months, 24 days
Occupation: Farmer
Birthplace: Knott Co., Ky.
Name of Father: Robert L. CORNETT
Birthplace Father: Ky.
Maiden name of Mother: Adaline BRASHEAR
Birthplace Mother: Ky.
Informant/Address: Wife, Sassafras, Ky.
Filed: 08 February 1930
Registrar: C. D. Combs
Death Date: 22 January 1930
I hereby certify that I attended deceased from 21 January
1930, to 22 January 1930, that I last saw her alive on 22
January 1930, and that death occurred, on the date stated
above at 11:30 a.m.
Cause of Death: Lobar pneumonia
Duration: 03 days
Contributory: Senility
Signed/Address: Arthur Vandevert, M.D., 06 February
1930, Allock, Ky.
Place of Burial or Removal: Cornett Cemetery
Date of Burial: 23 January 1930
Undertaker/Address: (blank)
Transcribed by Debbie Tamborski, 29 March 2010 |
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