Date: 30 September 1953
Cert: 27437
Place of Death: County: Knott
City or Town: Emmalena
Length of stay (in this place): (blank)
Street address or location: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Emmalena If rural give
location:
(blank)
Full Name: D. L. FULLER
Date of Death: 30 September 1953
Sex, Color or Race, Marital Status: Male, White, Widow
Date of Birth: 20 March 1870
Age: 83 years
Usual Occupation: Farmer
Kind of Industry or business: (blank)
Birthplace: Knott Co., Ky.
Father's Name: Arch FULLER
Mother's Maiden Name: Dicie COMBS
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Mrs. W. T. BYRD
Disease/condition directly leading to death: Coronary
Occlusion
Interval between onset and death: Instant
Due to: Hypertension & arteriosclerosis
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
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 04 May 1953 to
30 September 1953, that I last saw the deceased alive on 02
June 1953, and
that death occurred at a.m., from the causes and on the
date stated above.
Date signed: 10 December 1953
Address: Hazard, Ky.
Signature: Martin Palmer, M.D.
Burial, Cremation or Removal: Burial
Date: 02 October 1953
Name of Cemetery or Crematory: Fuller Cemetery
Location: Emmalena, Ky.
Date received by local registrar: 03 January 1954
Registrar's Signature: Mrs. Rose B. Craft
Funeral director & address: John Everage, Hindman,
Ky.
Transcribed by Debbie Tamborski, 07 February 2011 |