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DEATH
CERTIFICATE
RAYMOND DANIELS
Date 20 August 1940
Cert: 25684
Place of Death: County: Floyd City or Town:
Martin
Name of Hospital or Institution: Martin General Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Garner, Ky.
Full Name: Raymond DANIELS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Birth date of deceased: 02 December 1926
Age: 14 years, 08 months, 18 days
Birthplace: student
Occupation: (blank)
Industry or business: (blank)
Father Name: Charlie DANIELS
Father Birthplace: Lawrence Co., Ky.
Mother Maiden Name: Hazel SLONE
Mother Birthplace: Knott Co., Ky.
Informant: Charlie DANIELS, Garner, Ky.
Burial Place: Garner, Ky.
Date: 22 August 1940
Signature of funeral director: E. R. Arnold,
Prestonsburg, Ky.
Date received by local registrar: 24 November 1940
Registrar's Signature: Mrs. Ben Norris
Date of Death: 20 August 1940
I hereby certify that I attended deceased from 20 August 1940
to 20 August 1940, that I last saw him alive on 20 August
1940, and that death occurred on the date stated above at 6:00
p.m.
Immediate cause of death: Urinary retention Interstitial
Other conditions: Acute nephritis
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: C. L. Allen, M.D., Martin, Ky.
Date signed: 24 November 1940
Transcribed by Debbie Tamborski, 30 January 2010 |
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