Date: 07 January 1949
Cert: 01226
Place of Death: County: Knott
City or Town: Lackey, Ky.
Name of Hospital or Institution: Stumbo Hosp.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Floyd
City or Town: Martin, Ky.
Full Name: Tracy C. CRISP
If Veteran Name War: II
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: 17 January 1913
Age: 35 years
Birthplace: Martin, Ky.
Occupation: Farmer
Industry or business: "
Father Name: Faris CRISP
Father Birthplace: Martin, Ky.
Mother Maiden Name: Dollie STEPHENS
Mother Birthplace: Martin, Ky.
Informant: Monie MAYS, Martin, Ky.
Burial Place: Martin, Ky.
Date: 09 January 1949
Signature of funeral director: G. D. Ryan, Martin, Ky.
Date received by local registrar: 18 January 1949
Registrar's Signature: Rose B. Craft
Date of Death: 07 January 1949
I hereby certify that I attended deceased from 06 January 1949
to 07 January 1949, that I last saw him alive on 07 January
1949, and that death occurred on the date stated above at 3
a.m.
Immediate cause of death: Cardiac arrest
Duration: (blank)
Due to: Alcoholism, acute, severe
Other conditions: Gastritis, acute, severe, sec. to #1
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: Robert D. Eastridge, M.D., Lackey, Ky.
Date signed: 18 January 1949
Transcribed by Debbie Tamborski, 04 January 2011 |