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DEATH
CERTIFICATE
ARCH C. CRAFT
Date 25 December 1941
Cert: 28007
Place of Death: County: Bourbon City or Town:
Paris
Name of Hospital or Institution: Massie Hosp.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County: Bourbon
City or Town: Rural Street No.:
R#5 Paris, Ky.
Full Name: Arch C. CRAFT
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Ruth SMITH
Age of husband or wife if alive: (blank)
Birth date of deceased: 10 April 1871
Age: 70 years, 08 months, 15 days
Birthplace: Knott Co., Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Nelson CRAFT
Father Birthplace: Kentucky
Mother Maiden Name: Eliza REYNOLDS
Mother Birthplace: Virginia
Informant: Mrs. Ruth SMITH CRAFT, Bourbon Co., Ky.
Burial Place: Mallie, Knott Co., Ky.
Date: 28 December 1941
Signature of funeral director: Davis Funeral Home,
Paris, Ky.
Date received by local registrar: 05 January 1942
Registrar's Signature: Lavalette R. Orr
Date of Death: 25 December 1941
I hereby certify that I attended deceased from (blank) to
25 December 1941, that I last saw him alive on 25 December
1941, and that death occurred on the date stated above at 9:45
p.m.
Immediate cause of death: Pneumonia Fever Perforated
Duodenal Ulcer
Duration: 27 December 1941
Due to: Coronary Heart Disease
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: (illegible), Paris, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 12 May 2010 |
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