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DEATH
CERTIFICATE
MISS HATTIE DAVIS
Date 13 December 1936
Cert: 2023
Name: Miss Hattie DAVIS
Place of Death: Vot Pct. Stumbo Hosp., Lackey, Knott Co., KY
Residence: Hueysville, Ky., Floyd Co.
Length of residence: (blank)
Female, White, Divorced & Widow
Husband or Wife of: Corbin COLLINS
Birth Date: (blank)
Age: 42 years, 01 months, 13 days
Occupation: Domestic
Place of Birth: Hueysville, Ky.
Name of Father: Hattie DAVIS (transcribed as written)
Birthplace Father: Hueysville, Ky.
Maiden Name of Mother: Hattie Davis (transcribed as written)
Birthplace Mother: Hueysville, Ky.
Informant: Frank DAVIS (brother), Garrett, Ky.
Death Date: 13 December 1936
Cause of Death: Inflammatory Rheumatism
(illegible) Contributory: Myocarditis &
Endocarditis
Signed: John O. Salyers, M.D., Stumbo Mem.
Hosp., Lackey, Ky.
Burial Place: W. Garrett, Ky.
Date of Burial: 15 December 1936
Undertaker: Family, Garrett, Ky.
File Date: 23 January 1937
Transcribed by Debbie Tamborski, 18 September 2009 |
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