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DEATH
CERTIFICATE
BRENDA FIELDS
Date 11 August 1950
Cert: 21444
Place of Death: County: Perry City or Town:
Hazard
Length of stay in hospital or community:
Name of Hospital or Institution: Mt. Mary Hospital
Usual Residence of Deceased: State: Kentucky County: Knott
City or Town: Smithsboro
Full Name: Brenda FIELDS
Date of Death: 11 August 1950
Sex, Color/Race, Marital Status: Female, White, Never Married
Date of Birth: 11 August 1950
Age: 04 hours
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Smithsboro, Ky.
Father's Name: Frank FIELDS
Mother's Maiden Name: Tefa MULLINS
Was deceased in ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Mrs. Breck MULLINS
Disease or condition directly leading to death:
Atelectasis
Interval between onset and death: (blank)
Due to: Prematurity
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings for operation: (blank)
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 11 August 1950 to
11 August 1950, that I
last saw the deceased alive on 11 August 1950, and that death occurred on
the date stated above at 2:50 p.m., from the causes and on the date
stated above.
Date signed: (blank)
Address: (blank)
Signature: Richard Borman, M.D.
Burial, Cremation or Removal: (blank)
Date: (blank)
Name of Cemetery or Creamatory: Combs Cemetery
Location: Smithsboro, Ky.
Date received by local registrar: 19 September 1950
Registrar's Signature: Georgia Pendleton
Funeral director and address: (blank)
Transcribed by Debbie Tamborski, 16 February 2010 |
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