|
DEATH
CERTIFICATE
BROWNLOE FIELDS
Date 19 September 1941
Cert: 23079
Place of Death: County: Perry City or Town:
Hazard
Name of Hospital or Institution: Hazard Hosp. Co.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Rural
Full Name: Brownloe FIELDS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Della FIELDS
Age of husband or wife if alive: 19 years
Birth date of deceased: 14 June 1919
Age: 22 years
Birthplace: Letcher Co., Ky.
Occupation: Coal Miner
Industry or business: (blank)
Father Name: Dave FIELDS
Father Birthplace: Ky.
Mother Maiden Name: Bessie COOK
Mother Birthplace: Ky.
Informant: Francis FIELDS, Jenkins, Ky.
Burial Place: Sasfrass, Ky.
Date: 20 September 1941
Signature of funeral director: Engle Und. & Hdwe., Hazard, Ky.
Date received by local registrar: 30 September 1941
Registrar's Signature: Kathryn S. Johnson
Date of Death: 19 September 1941
I hereby certify that I attended deceased from 18 September
1941 to 19 September 1941, that I
last saw him alive on 19 September 1941, and that death occurred on the date
stated above at 8:15 a.m.
Immediate cause of death: Second & third degree burns of
entire body & face
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: Accidental
Date of occurrence: 18 September 1941
Where did injury occur: Coal mine
While at work: yes
Means of injury: Powder explosion
Signature: Chris S. Johnson, M.D., Hazard, Ky.
Date signed: 22 September 1941
Transcribed by Debbie Tamborski, 01 February 2010 |
|