Date: 29 April 1949
Cert: 101113
Place of Death: County: Knott
City or Town: Sasasfrass
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Sasassfrass Street Address:
(blank)
Full Name: Andrew Jackson FIELDS
Date of Death: 29 April 1949
Sex, Color or Race, Marital Status: Male, White, Widowed
Date of Birth: 10 October 1873
Age: 76 years
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Perry County
Father's Name: Davis FIELDS
Mother's Maiden Name: Sallie MULLINS
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Ira COMBS
Disease or condition directly leading to death: Senility
Interval between onset and death: (blank)
Due to: Natural Causes
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 01 April 1949 to
29 April 1949, that I last saw the deceased alive on 28 April
1949, and
that death occurred at 6 a.m., from the causes and on the
date stated above.
Date signed: 03 May 1949
Address: Allock, Ky.
Signature: A. B. Pigman, M.D.
Burial, Cremation or Removal: Burial
Date: 01 May 1949
Name of Cemetery or Crematory: Combs Cem.
Location: Knott County, Ky.
Date received by local registrar: 14 May 1949
Registrar's Signature: Rose B. Craft
Funeral director & address: Engles, Hazard, Ky.
Transcribed by Debbie Tamborski, 04 January 2011 |