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DEATH
CERTIFICATE
CLOVIE DIAMOND
Date 28 January 1935
Cert: 02015
Place of Death: Voting Pct.: Colson, Letcher Co., Ky.
Full Name: Clovie DIAMOND
Residence: Lester, Ky.
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Female, White, Child
Husband or Wife of: Child
Date of Birth: 28 January 1935 (transcribed as written)
Age: 03 years, 09 months, 02 days
Occupation: Child
Birthplace: Knott Co., Ky.
Father Name: Henry DIAMOND
Birthplace Father: Knott Co., Ky.
Mother Maiden Name: Rachel HAMPTON
Birthplace Mother: Letcher Co., Ky.
Informant/Address: Martha CRASE, Sandlick, Ky.
Burial Cremation Removal Place: Lucas Cemetery
Date: 29 January 1935
Undertaker/Address: Family, Colson, Ky.
Filed: 31 January 1935
Registrar: J. Don Collins
Death of Date: 28 January 1935
I hereby certify, That I attended deceased from (blank) to
(blank), that I last saw her alive on (blank), death is said
to have occurred on the date stated above, at 3 a.m.
Cause of Death: Broncho pneumonia
Date of onset: 1 week
Contributory causes: none
Name of operation: no Was there an
autopsy: no
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: none
Nature of injury: (blank)
Related to occupation: (blank)
Signed/Address: R. H. Collins, M.D., Whitesburg, Ky.
Transcribed by Debbie Tamborski, 17 April 2010 |
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