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DEATH
CERTIFICATE
IDA MAE GAYHART
Date 04 August 1952
Cert: 22203
Place of Death: County: Pike City or Town:
Pikeville
Length of stay in hospital or community: 01 week
Name of Hospital or Institution: Methodist Hospital
Usual Residence of Deceased: State: Ky. County: Knott
City or Town: Rural
Location: Carrie, Ky.
Full Name: Ida Mae GAYHART
Date of Death: 04 August 1952
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 16 December 1896
Age: 55 years
Usual Occupation: Housewife
Kind of Industry or business: Keeping house
Birthplace: Knott Co., Ky.
Father's Name: W. M. COX
Mother's Maiden Name: Susan STACY
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Cash GAYHART
Disease or condition directly leading to death: Uremia &
pulmonary edema
Interval between onset and death: (blank)
Due to: Operation - D. & C. (illegible) anesthia
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 (blank), from the causes and on the date
stated above.
Date signed: 13 August 1952
Address: Pikeville, Ky.
Signature: Charles C. Rutledge, M.D.
Burial, Cremation or Removal: Burial
Date: 09 August 1952
Name of Cemetery or Creamatory: Cornett Cemetery
Location: Hindman, Ky.
Date received by local registrar: 18 August 1952
Registrar's Signature: Helen A. (illegible)
Funeral director and address: John N. Taul, Hindman, Ky.
Transcribed by Debbie Tamborski, 20 February 2010 |
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