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DEATH
CERTIFICATE
ETHEL DOBSON
Date 31 January 1929
Cert: 05474
Place of Death: Voting Pct: Horse Creek #23, Clay Co.,
Ky.
Full Name: Ethel DOBSON
Residence: (blank)
Length of Residence in city where death occurred:
(blank)
Sex, Color or Race, Marital Status: Female, White,
Single
Husband or Wife of: (blank)
Date of Birth: 24 January 1915
Age: 14 years, 07 days
Occupation: Student
Birthplace: Knott Co., Ky.
Father Name: James DOBSON
Birthplace Father: Knott Co., Ky.
Mother Maiden Name: Sarah KELLEY
Birthplace Mother: Knott Co., Ky.
Informant/Address: Ed HENSLEY, Pigeon Roost
Filed: 01 February 1929
Registrar: Mrs. W. (illegible)
Death of Date: 31 January 1929
I hereby certify that I attended deceased from 16 January 1929 to
31 January 1929, that I last saw her alive on 31 January 1929,
and that death occurred on the date stated above at 10:00 p.m.
Cause of Death: Lobar pneumonia migratory form
Duration: 16 days
Contributory: (blank)
Duration: (blank)
Where was disease contracted if not at place of death?:
(blank)
Did an operation precede death: no Date: (blank)
Was there an autopsy: no
What test confirmed diagnosis: (blank)
Signed/Address: J. A. Baker, M.D., 01 February 1929
Place of Burial or Removal: Pigeon Roost
Date of Burial: 01 February 1929
Undertaker/Address: Family, Pigeon Roost, Ky.
Transcribed by Debbie Tamborski, 27 March 2010 |
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