Date: 03 September 1941
Cert: 22645
Place of Death: County: Knott Co. City or
Town: Lackey, Ky.
Name of Hospital or Institution: Stumbo Memorial Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Floyd
City or Town: Wayland, Ky.
Full Name: Gurtrude DEALS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 17 October 1941 (transcribed as
written)
Age: 10 months, 16 days
Birthplace: Wayland
Occupation: (blank)
Industry or business: (blank)
Father Name: Vadis DIALS
Father Birthplace: Knott Co.
Mother Maiden Name: Tilda MULLINS
Mother Birthplace: Knott Co.
Informant: Vadis DIALS, Wayland, Ky.
Burial Place: Wayland, Ky.
Date: 04 September 1941
Signature of funeral director: O. T. Lemaster, Martin, Ky.
Date received by local registrar: 22 September 1941
Registrar's Signature: Phena Slone
Date of Death: 03 September 1941
I hereby certify that I attended deceased from 03 September
1941 to
03 September 1941, that I last saw her alive on 03 September
1941, and that death occurred on the date stated above at 11
a.m.
Immediate cause of death: Bronchopneumonia
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: C. R. Messer, M.D., Lackey, Ky.
Date signed: 18 September 1941
Transcribed by Debbie Tamborski, 12 October 2010 |