Date: 10 August 1946
Cert: 17886
Place of Death: County: Knott City or
Town: Tina, Ky. Rural
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: Tina Rural
Full Name: William COX
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White,
Widowed
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 04 July 1871
Age: 75 years,01 months, 06 days
Birthplace: Letcher Co.
Occupation: Farmer
Industry or business: (blank)
Father Name: John COX
Father Birthplace: Letcher
Mother Maiden Name: Ledy COX
Mother Birthplace: Letcher
Informant: Claude COX, Tina, Ky.
Burial Place: Knott
Date: 12 August 1946
Signature of funeral director: Engle's, Hazard, Ky.
Date received by local registrar: 31 August 1946
Registrar's Signature: Mrs. Rose B. Craft
Date of Death: 10 August 1946
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: Heath failure
Duration: (blank)
Due to: Dilation Heart
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: J. W. Duke, M.D., Hindman, Ky.
Date signed: 31 August 1946
Transcribed by Debbie Tamborski, 04 December 2010 |