Date: 26 January 1946
Cert: 04584
Place of Death: County: Knott City or
Town: Amburgey, Ky. Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Amburgey Rural
Full Name: Ben Jack EVERAGE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White,
Married
Husband or Wife of: Lizzie MULLINS
Age of husband or wife if alive: 63 years
Birth date of deceased: 08 October 1884
Age: 61 years, 03 months, 18 days
Birthplace: Amburgey, Ky.
Occupation: Farmer
Industry or business: Farm
Father Name: Adam JOHNSON
Father Birthplace: Amburgey, Ky.
Mother Maiden Name: Millie WATTS
Mother Birthplace: Knott Co., Ky.
Informant: Tom his X mark BEVELRY, Anco, Ky.
Burial Place: Mary Franklin Cemetery
Date: 28 January 1946
Signature of funeral director: Friends, Amburgey, Ky.
Date received by local registrar: 12 February 1946
Registrar's Signature: Mrs. Rose B. Craft
Date of Death: 26 January 1946
I hereby certify that I attended deceased from 20 January 1946 to
25 January 1946, that I last saw him alive on 25 January 1946,
and that death occurred on the date stated above at 3:00 a.m.
Immediate cause of death: Cardiac insufficiency
Duration: (blank)
Due to: Hypoglycemia in diabetic condition (mellitus &
insipidus combined)
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: J. R. Aker, M.D., Anco, Ky.
Date signed: 09 February 1946
Transcribed by Debbie Tamborski, 07 December 2010 |