Date: 06 June 1954
Cert: 26522
Place of Death: County: Knott
City or Town: Lackey - Rural
Length of stay (in this place): 26 hours
Name of Hospital or Institution: Stumbo Memorial Hosp.
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Hindman - Rural If rural give
location:
(blank)
Full Name: Ben FAIR
Date of Death: 06 June 1954
Sex, Color or Race, Marital Status: Male, White, Never Married
Date of Birth: 05 February 1925
Age: 29 years
Usual Occupation: Laborer
Kind of Industry or business: Various
Birthplace: Ky.
Father's Name: Bud FAIR
Mother's Maiden Name: Ruth LAWSON
Was deceased ever in armed forces: No
Social Security No.: 404-28-6451
Informant: (blank)
Disease or condition directly leading to death: Intracranial
hemorrhage
Interval between onset and death: 24 hours
Due to (b): Skull fracture
Due to (c): Auto accident
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: Accident
Place of injury: Highway
City or Town, County, State: Hindman, Knott, Ky.
Time of Injury: 05 June 1954, 11 a.m.
Injury occurred at work: Not while at work
How did injury occur: Automobile Accident
I hereby certify that I attended deceased from 06 June 1954 to
06 June 1954, that I last saw the deceased alive on 06 June
1954, and
that death occurred at 3:00 p.m., from the causes and on the
date stated above.
Date signed: 18 June 1954
Address: Stumbo Memorial Hosp., Lackey, Ky.
Signature: Charles L. Roach, M.D.
Burial, Cremation or Removal: Burial
Date: 08 June 1954
Name of Cemetery or Crematory: Gayhart Cemetery
Location: Hindman, Ky.
Date received by local registrar: 24 February 1955
Registrar's Signature: Myrtle Slone
Funeral director & address: John N. Taul, Hindman
Funeral Home, Hindman, Ky.
Transcribed by Debbie Tamborski, 24 February 2011 |