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DEATH
CERTIFICATE
Mrs. KARL E.
DAVIS Sr.
Date 17 January 1939
Cert: 04645
Place of Death: Voting Pct. #29 Corbin, Knox Co., Ky.
Full Name: Mrs. Karl E. DAVIS Sr.
Residence: 405 Master Corbin
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Female, White,
Widowed
Husband or Wife of: Karl E. DAVIS Sr.
Date of Birth: 10 December 1889
Age: 49 years, 01 months, 07 days
Occupation: Housekeeper
Birthplace: Knott Co.
Father Name: D. W. WALLACE
Birthplace Father: Virginia
Mother Maiden Name: Hester A. BRUCE
Birthplace Mother: Virginia
Informant/Address: Karl E. Davis, Jr., Corbin, Ky.
Burial Cremation Removal Place: Whitesburg, Ky.
Date: 19 January 1939
Undertaker/Address: C. G. O'Neil & Son, Corbin, Ky.
Filed: 08 February 1939
Registrar: Mrs. J. S. Lork
Death of Date: 17 January 1939
I hereby certify, That I attended deceased from 13 January
1939 to 17 January 1939, that I last saw her alive on 17
January 1939, death is said to have occurred on the date
stated above, at 3 p.m.
Cause of Death: (illegible) Coccic infection
Date of onset: 19 Janaury 1939
Contributory causes: (blank)
Name of operation: (blank)
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: (blank)
Signed/Address: W. M. Brown, M.D., Corbin, Ky.
Transcribed by Debbie Tamborski, 03 May 2010 |
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