Date: 02 May 1944
Cert: 13028
Place of Death: County: Knott City or
Town: Lackey
Name of Hospital or Institution: Stumbo Mem. Hosp.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Floyd
City or Town: West Prestonsburg
Full Name: Wilburn Martin ELLIOTT
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Annie ELLIOTT
Age of husband or wife if alive: 50 years
Birth date of deceased: 02 March 1867
Age: 77 years, 02 months, 00 days
Birthplace: Floyd Co., Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Robert S. ELLIOTT
Father Birthplace: Floyd Co., Ky.
Mother Maiden Name: Lurania HAMILTON
Mother Birthplace: Floyd Co., Ky.
Informant: Robert C. ELLIOTT, Pikeville, Ky.
Burial Place: Beaver, Ky.
Date: 05 May 1944
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: (blank)
Registrar's Signature: (blank) Per B. Carns
Date of Death: 02 May 1944
I hereby certify that I attended deceased from 02 May 1944 to
02 May 1944, that I last saw him alive on (blank), and that
death occurred on the date stated above at 4:45 p.m.
Immediate cause of death: Cardiac Failure
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: A. N. Hodge, M.D., Lackey, Ky.
Date signed: 14 March 1945
Transcribed by Debbie Tamborski, 12 November 2010 |