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DEATH
CERTIFICATE
Not Named
Date 18 October 1935
Cert: 27730
Name: Not Named
Place of Death: Voting Pct. Tiney, Knott Co., KY
Residence: (blank)
Length of residence: (blank)
Male, White, Single
Husband or Wife of: none
Birth Date: (blank)
Age: (illegible)
Occupation: none
Place of Birth: Knott Co., Ky.
Name of Father: Joe EVERIDGE
Birthplace Father: Ky.
Maiden Name of Mother: Matilda ROBERTS
Birthplace Mother: Kentucky
Informant: Joe EVERIDGE, Tiney, Ky.
Death Date: 18 October 1935
I hereby certify that I attended deceased from Oct. 18, 1935
to Oct. 25, 1935. I last saw him alive on Oct. 18, 1935, death
is said to have occurred on the date stated above, at 10 p.m.
Cause of Death: Lobar pneumonia
Signed: M. F. Kelly, M.D., Hindman, Ky.
Burial Place: Everage Cem.
Date of Burial: 25 October 1935
Undertaker: Joe Everage, Tiney
File Date: 15 November 1935
Transcribed by Debbie Tamborski, 12 August 2009 |
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