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DEATH
CERTIFICATE
KAY DOBSON
Date: 03 December 1947
Cert: 28903
Place of Death: County: Perry City or Town:
Glomar
Street No. or Location: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Perry
City or Town: Glomar
Full Name: Kay DOBSON
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 November 1947
Age: 00 years, 00 months, 14 days
Birthplace: Knott
Occupation: (blank)
Industry or business: (blank)
Father Name: Truman DOBSON
Father Birthplace: Perry
Mother Maiden Name: Sara DOBSON
Mother Birthplace: Knott
Informant: Truman DOBSON, Glomar, Ky.
Burial Place: Glomar (Perry)
Date: 04 December 1947
Signature of funeral director: Engles, Hazard, Ky.
Date received by local registrar: 06 January 1948
Registrar's Signature: Cleata D. Cox
Date of Death: 03 December 1947
I hereby certify that I attended deceased from 17 November
1947 to
01 December 1947, that I last saw him alive on 01 December
1947, and that death
occurred on the date stated above at (blank)
Immediate cause of death: Cardio-renal Disease
Duration: (blank)
Due to: Malnutrition
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: A. B. Pigman, M.D., Allock
Date signed: 03 December 1947
Transcribed by Debbie Tamborski, 23 June 2010 |
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