Date: 09 July 1941
Cert: 20357
Place of Death: County: Knott City or
Town: Lackey
Name of Hospital or Institution: Stumbo Memorial Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Floyd
City or Town: Dorton, Ky. Street
No.: Pike Co.
Full Name: Rosee EASTEP
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: D. B. EASTEP
Age of husband or wife if alive: 44 years
Birth date of deceased: 18 April 1900
Age: 41 years, 02 months
Birthplace: Pike Co.
Occupation: Domestic
Industry or business: (blank)
Father Name: Abel COLLIER
Father Birthplace: Pike Co.
Mother Maiden Name: Anna SLONE
Mother Birthplace: Pike Co.
Informant: D. B. EASTEP, Dorton, Ky.
Burial Place: Dorton, Ky.
Date: 10 July 1941
Signature of funeral director: O. T. Lemaster, Martin, Ky.
Date received by local registrar: 15 August 1941
Registrar's Signature: Phena Slone
Date of Death: 09 July 1941
I hereby certify that I attended deceased from 05 July 1941 to
09 July 1941, that I last saw her alive on 09 July 1941, and
that death occurred on the date stated above at 5:30 a.m.
Immediate cause of death: (illegible)
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: (blank)
Date signed: (blank)
Transcribed by Debbie Tamborski, 12 October 2010 |