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DEATH
CERTIFICATE
LILLIE B. CUNDIFF
Date 10 February 1943
Cert: 02875
Place of Death: County: Breathitt City or Town:
Elkatawa
Street No. or Location: (Rural)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky County: Breathitt
City or Town: Elkatawa Street
No.: (Rural)
Full Name: Lillie B. CUNDIFF
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: George W. CUNDIFF
Age of husband or wife if alive: 58 years
Birth date of deceased: 26 April 1897
Age: 55 years, 09 months [sic]
Birthplace: Knott County
Occupation: Housewife
Industry or business: (blank)
Father Name: Hiram ENGLE
Father Birthplace: Knott Co.
Mother Maiden Name: Delilah FRANCIS
Mother Birthplace: Knott Co.
Informant: (blank)
Burial Place: Little Cem.
Date: 12 February 1943
Signature of funeral director: Ray & Blake, Jackson, Ky.
Date received by local registrar: 12 February 1943
Registrar's Signature: Beatrice Eversole
Date of Death: 10 February 1943
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 a.m.
Immediate cause of death: Carcinoma of Colen
Duration: (blank)
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 & Address: Paul A. Wright, M.D., Jackson
Date signed: 04 March 1943
Transcribed by Debbie Tamborski, 30 May 2010 |
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