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DEATH
CERTIFICATE
RHODA DAY
Date 18 May 1941
Cert: 18433
Place of Death: County: Perry City or Town:
Rural
Street No. or Location: Lothair
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County: Perry
City or Town: Rural Street No.:
#36
Full Name: Rhoda DAY
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Widowed
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 29 April 1861
Age: 80 years
Birthplace: Knott Co., Ky.
Occupation: House Keeper
Industry or business: (blank)
Father Name: John STACY
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: ? [sic]
Mother Birthplace: ? [sic]
Informant: Melvin JENT, Hazard
Burial Place: Brinkley, Ky.
Date: 19 May 1941
Signature of funeral director: Engle Und. & Hdwe., Hazard, Ky.
Date received by local registrar: 07 July 1941
Registrar's Signature: Kathryn S. Johnson
Date of Death: 18 May 1941
I hereby certify that I attended deceased from 15 May 1941 to
18 May 1941, that I last saw her alive on 18 May 1941, and
that death occurred on the date stated above at 4 a.m.
Immediate cause of death: Lobar Pneumonia
Duration: 03 days
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: Chas D. Snyder, M.D., Hazard,
Ky.
Date signed: 30 June 1941
Transcribed by Debbie Tamborski, 12 May 2010 |
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