Date: 18 April 1955
Cert: #9989
Place of Death: County: Knott City or Town:
Hindman - Rural
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Hindman - Rural Street Address: (blank)
Full Name: Eliott DYER
Date of Death: 18 April 1955
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 13 December 1876
Age: 78 years
Usual Occupation: Farmer
Kind of Industry or business: (blank)
Birthplace: Letcher Co., Ky.
Father's Name: Green DYER
Mother's Maiden Name: Claren GAYHEART
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Mrs. Eliott DYER
Disease or condition directly leading to death: Disease
of the heart and Disease of Kidneys
Interval between onset and death: (blank)
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 01 April 1955 to
18 April 1955, that I last saw the deceased alive on 16 April
1955, and
that death occurred at 6 a.m., from the causes and on the
date stated above.
Date signed: 25 April 1955
Address: Hindman, Ky.
Signature: M. F. Kelley
Burial, Cremation or Removal: Burial
Date: 20 April 1955
Name of Cemetery or Crematory: Dyer Cemetery
Location: Hindman, Ky.
Date received by local registrar: 13 May 1955
Registrar's Signature: Myrtle Slone
Funeral director & address: John Everage, Hindman,
Ky.
Transcribed by Debbie Tamborski, 14 May 2011 |