|
DEATH
CERTIFICATE
CARRIE GAYHEART
Date 20 February 1952
Cert: 13261
Place of Death: County: Perry City or Town:
Hazard
Length of stay in hospital or community: 01 week
Name of Hospital or Institution: Mt. Mary Hospital
Usual Residence of Deceased: State: Ky. County: Knott
City or Town: Rural Location:
Softshell
Full Name: Carrie GAYHEART
Date of Death: 20 February 1952
Sex, Color or Race, Marital Status: Female, White,
Married
Date of Birth: Date unknown
Age: 42 years
Usual Occupation: Housewife
Kind of Industry or business: Keeping House
Birthplace: Knott County, Ky.
Father's Name: Will COMBS
Mother's Maiden Name: Cora SMITH
Was deceased ever in armed forces: No
Social Security No.: None
Informant: Preston GAYHEART
Disease or condition directly leading to death: Uremia
Due to: Chronic Pyelonephritis
Interval between onset and death: 02 years
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:
Address:
Signature: Ernest A. Jolia, M.D.
Burial, Cremation or Removal: Burial
Date: 23 February 1952
Name of Cemetery or Creamatory: Gayheart Cemetery
Location: Softshell, Knott, Ky.
Date received by local registrar: 22 May 1952
Registrar's Signature: George P. Surer
Funeral director and address: John N. Taul, Hindman, Ky.
Transcribed by Debbie Tamborski, 20 February 2010 |
|