Date: 10 November 1945
Cert: 23985
Place of Death: County: Knott City or
Town: Hindman, Ky. Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Hindman Rural
Full Name: Mrs. Louella COMBS FUGATE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Widowed
Husband or Wife of: John FUGATE
Age of husband or wife if alive: Deceased
Birth date of deceased: 10 March 1885
Age: 60 years, 08 months, 00 days
Birthplace: Letcher Co., Ky.
Occupation: Housewife
Industry or business: (blank)
Father Name: Shade COMBS
Father Birthplace: Ky.
Mother Maiden Name: Elizabeth LOGAN
Mother Birthplace: Rock House, Letcher Co.,
Ky.
Informant: H. H. SMITH, Hindman, Ky.
Burial Place: Hindman Rural
Date: 11 November 1945
Signature of funeral director: Joe Greer, Hazard, Ky.
Date received by local registrar: 15 November 1945
Registrar's Signature: Rose B. Craft
Date of Death: 10 November 1945
I hereby certify that I attended deceased from (blank) to
10 November 1945, that I last saw him alive on 09 November
1945, and that death
occurred on the date stated above at 3 a.m.
Immediate cause of death: Cirrhosis of the liver
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, M.D., Hindman
Date signed: 15 November 1945
Transcribed by Debbie Tamborski, 27 November 2010 |