|
DEATH
CERTIFICATE
LELA FRIEND
Date 05 June 1940
Cert: 14268
Place of Death: County: Fayette City or Town:
Lexington
Name of Hospital or Institution: Eastern State Hospital,
Lexington, Ky.
Length of stay in hospital or community: 06 months, 26 days
Usual Residence of Deceased: State: Kentucky County:
Boyd
City or Town: Ashland Street
No.: 121-17th St.
Full Name: Lela FRIEND
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: John FRIEND
Age of husband or wife if alive: (blank)
Birth date of deceased: (blank)
Age: 35 years
Birthplace: Knott County, Ky.
Occupation: Housewife
Industry or business: (blank)
Father Name: W. B. FRANKLIN
Father Birthplace: Don't Know
Mother Maiden Name: Dead
Mother Birthplace: Don't Know
Informant: Hospital Records, Lexington,
Ky., Eastern State Hospt.
Burial Place: Nicholasville, Ky.
Date: 05 June 1940
Signature of funeral director: Guyen & Kuntz, Nicholasville,
Ky.
Date received by local registrar: 10 June 1940
Registrar's Signature: D. A. Furlong
Date of Death: 05 June 1940
I hereby certify that I attended deceased from 09 November
1939 to
05 June 1940, that I last saw her alive on 05 June 1940, and
that death occurred on the date stated above at 2:45 p.m.
Immediate cause of death: Pulmonary Tuberculosis
Duration: 07 months
Due to: Dementia Praecox - Hebephrenic Type
Duration: 1939
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: C. C. Connel, M.D., Eastern
State Hosp.
Date signed: 05 June 1940
Transcribed by Debbie Tamborski, 08 May 2010 |
|