|
DEATH
CERTIFICATE
ASTOR FUGATE
Date 14 March 1949
Cert: 12815
Place of Death: County: Perry City or
Town: Hazard
Length of stay in hospital or community: (blank)
Name of Hospital or Institution: Mt. Mary
Usual Residence of Deceased: State: Ky. County: Knott
City or Town: Talcum
Full Name: Astor FUGATE
Date of Death: 14 March 1949
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 24 June 1912
Age: 36 years
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Perry
Father's Name: John FUGATE
Mother's Maiden Name: Lettie FUGATE
Was deceased in ever in armed forces: (blank)
Social Security No.: (blank)
Informant: John FUGATE
Disease or condition directly leading to death:
Carcinoma of stomach
Due to: (blank)
Interval between onset and death: (blank)
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 (blank) to
(blank), that I last saw the deceased alive on (blank), and
that death occurred on the date stated above at 5:30 p.m.,
from the causes and on the date stated above.
Date signed: (blank)
Address: Hazard, Ky.
Signature: (illegible) Palmer
Burial, Cremation or Removal: (blank)
Date: 17 March 1949
Name of Cemetery or Creamatory: Fugate
Location: Knott, Ky.
Date received by local registrar: 21 March 1949
Registrar's Signature: Helen C. Burriss
Funeral director and address: Engle's, Hazard, Ky.
Transcribed by Debbie Tamborski, 15 February 2010 |
|