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DEATH
CERTIFICATE
SUSAN FRANCIS
Date 07 August 1930
Cert: 21639
Place of Death: Voting Pct: Asylum, Eastern State
Hospital, Lexington, Fayette Co., Ky.
Full Name: Susan FRANCIS
Residence: Cody, Ky.
Length of Residence in city where death occurred:
(blank)
Sex, Color or Race, Marital Status: Female, Colored,
Married
Husband or Wife of: London FRANCIS
Date of Birth: (blank)
Age: 37 years
Occupation: Housewife Nature of
industry: Housework
Birthplace: Knott Co., Ky.
Father Name: J. R. WILLIAMS
Birthplace Father: not given
Mother Maiden Name: not given
Birthplace Mother: not given
Informant/Address: E. S. Hospt. Records, Lexington, Ky.
Filed: 17 September 1931
Registrar: D. A. Furlong
Death of Date: 07 August 1930
I hereby certify that I attended deceased from 05 August 1930 to
07 August 1930, that I last saw her alive on 07 August 1930,
and that death occurred on the date stated above at 6 a.m.
Cause of Death: Nephritis
Duration: (blank)
Contributory: (blank)
Duration: (blank)
Where was disease contracted if not at place of death?:
(blank)
Did an operation precede death: no Date: (blank)
Was there an autopsy: no
What test confirmed diagnosis: usual
Signed/Address: T. T. Wendell, M.D., 08
August 1930, E. S. Hospital
Place of Burial or Removal: (?J.W. Nution?) Cemetery
Date of Burial: 08 August 1930
Undertaker/Address: E. S. Hospt. Employee, Lex., Ky.
Transcribed by Debbie Tamborski, 29 March 2010 |
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