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DEATH
CERTIFICATE
JOHN DIXON CORNETT
Date 23 July 1947
Cert: 20825
Place of Death: County: Perry Co. City or
Town: Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Rural
Full Name: John Dixon CORNETT
If Veteran Name War: Spanish American
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Widowed
Husband or Wife of: deceased
Age of husband or wife if alive: (blank)
Birth date of deceased: 10 February 1871
Age: 76 years, 05 months, 13 days
Birthplace: Sassafras, Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Robert S. CORNETT
Father Birthplace: Sassafras, Ky.
Mother Maiden Name: Adaline BRASHEAR
Mother Birthplace: Viper, Ky.
Informant: Kirby CORNETT
Burial Place: Cornett Hill
Date: 24 July 1947
Signature of funeral director: Maggard-Blair-&Garrett,
Hazard, Ky.
Date received by local registrar: 27 July 1947
Registrar's Signature: (illegible) Combs
Date of Death: 23 July 1947
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 5:22 a.m.
Immediate cause of death: Carcinoma of (illegible) &
liver
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: R. L. Collins, M.D., Hazard, Ky.
Date signed: 27 July 1947
Transcribed by Debbie Tamborski, 12 February 2010 |
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