Date: 13 March 1944
Cert: 13004
Place of Death: County: Knott City or
Town: Amburgy
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: Amburgy
Full Name: Amanda FIELDS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: A. J. FIELDS
Age of husband or wife if alive: 72 years
Birth date of deceased: 11 March 1879
Age: 65 years, 00 months, 02 days
Birthplace: Leslie Co., Kentucky
Occupation: Housewife
Industry or business: (blank)
Father Name: Sylvester COOTS
Father Birthplace: unknown
Mother Maiden Name: Elizabeth MUSSELWHITE
Mother Birthplace: unknown
Informant: Mrs. Troy FIELDS, Amburgy, Ky.
Burial Place: S. Combs Cem.
Date: 14 March 1944
Signature of funeral director: Family, Amburgy, Ky.
Date received by local registrar: March 1945
Registrar's Signature: Rose B. Craft
Acting Registrar Per B. Carns
Date of Death: 13 March 1944
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Apoplexy
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: J. R. Aker, M.D., Anco, Ky.
Date signed: 23 March 1945
Transcribed by Debbie Tamborski, 12 November 2010 |