Date: 26 September 1947
Cert: 24771
Place of Death: County: Knott City or
Town: Fisty, Ky. Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: Life
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Fisty Rural
Full Name: James Daniel FRANCIS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Gertie PERVIS
Age of husband or wife if alive: 36 years
Birth date of deceased: 1903
Age: 44 years
Birthplace: Knott Co., Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Alexander Z. FRANCIS
Father Birthplace: Kentucky
Mother Maiden Name: Sarilda SMITH
Mother Birthplace: Kentucky
Informant: Melda FUGATE, Fisty, Ky.
Burial Place: Home Cemetery, Clear Creek
Date: 28 September 1947
Signature of funeral director: Friends, Fisty, Ky.
Date received by local registrar: 16 November 1947
Registrar's Signature: Rose B. Craft By L. Roth
Date of Death: 26 September 1947
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: T. B.
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. W. Duke
Date signed: (blank)
Transcribed by Debbie Tamborski, 17 December 2010 |