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DEATH
CERTIFICATE
DELMAR FULLER
Date 25 March 1949
Cert: 04538
Place of Death: County: Fayette City
or Town: Lexington
Length of stay in hospital or community: 01 mo., 8 da.
Name of Hospital or Institution: Good Samaritan Hospital
Usual Residence of Deceased: State: Kentucky County:
Knott
City or Town: Emmalena
Full Name: Delmar FULLER
Date of Death: 25 March 1949
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 07 September 1908
Age: 40 years
Usual Occupation: Miner
Kind of Industry or business: (blank)
Birthplace: Emmalena, Ky.
Father's Name: D. L. FULLER
Mother's Maiden Name: Cynthia RITCHIE
Was deceased in ever in armed forces: No
Social Security No.: (blank)
Informant: wife
Disease or condition directly leading to death: circulatory
failure
Due to: glomerular nephritis, sub(illegible)
Interval between onset and death: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Autopsy: Yes
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 25
March 1949, that I last saw the deceased alive on 25 March
1949, and that death occurred on the date stated above at
(blank), from the causes and on the date stated above.
Date signed: (blank)
Address: (blank)
Signature: Oleas N. Kavanaugh
Burial, Cremation or Removal: Removal
Date: 27 March 1949 Transport Hazard, Ky. for
burial
Name of Cemetery or Creamatory: (blank)
Location: (blank)
Date received by local registrar: 28 March 1949
Registrar's Signature: D. A. Furlong
Funeral director/address: Lowe F. Home by
Merritt Martin, Lex., Ky.
Transcribed by Debbie Tamborski, 15 February 2010 |
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