|
DEATH
CERTIFICATE
HARGUS GAYHEART
Date 12 January 1917
Cert: 00918
Place of Death: Voting Precinct: Painter Harve, Weeksbury,
Floyd Co., Ky.
Full Name: Hargus GAYHEART
Sex, Color or Race, Marital Status: Male, White, Single
Date of Birth: 10 October 1902
Age: 14 years
Occupation: R. R. Grading
Birthplace: Beaver, Ky.
Name of Father: Edward GAYHEART
Birthplace Father: Va.
Maiden name of Mother: Susie VANCE
Birthplace Mother: Beaver, Ky.
Informant/Address: (blank)
Filed: 11 February 1917
Registrar: E. Hiram Hall
Death Date: 12 January 1917
I hereby certify that I attended deceased from 04 January 1917, to
12 January 1917, that I last saw him alive on 12 January 1917,
and that death occurred, on the date stated above, at 9 a.m.
Cause of Death: Measles
Duration: (blank)
Contributory: (blank)
Signed/Address: Dr. W. L. Stumbo, M.D., 11 February
1917, Weeksbury, Ky.
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: Beaver, Ky.
Date of Burial: 13 January 1917
Undertaker/Address: Edward Gayheart, Weeksbury, Ky.
Transcribed by Debbie Tamborski, 28 February 2010 |
|