Date: 15 October 1956
Cert: # 56-21314
Place of Death: County: Knott
City or Town: Rural
Length of stay (in this place): All of life
Street Address or Location: Softshell, Ky.
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Rural Residence
on a Farm?: Yes
Street Address: Softshell, Ky. Residence inside
City Limits?: No
Full Name: Lain GAYHEART
Date of Death: 15 October 1956
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 22 October 1875
Age: 80 years
Usual Occupation: Housewife
Kind of Industry or business: Wife
Birthplace: Knott Co., Ky.
Father's Name: Elijah COMBS
Mother's Maiden Name: Sisses MOORE
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Mrs. Bee BOLEN
Disease/condition directly leading to death: Carcinoma of
rectum
Interval between onset and death: 01 year
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
Accident, suicide, or homicide: (blank)
Describe how injury occurred: (blank)
Time of injury: (blank)
Injury occurred at work: (blank)
Place of injury: (blank)
City, Town or Location, County, State: (blank)
I hereby certify that I attended deceased from 19 March 1956 to
01 October 1956, that I last saw the deceased alive on 01
October 1956, and
that death occurred at ? (transcribed as written, from the causes and on the
date stated above.
Date signed: 20 October 1956
Address: Ary, Ky.
Signature: K. W. Cameron, M.D.
Burial, Cremation or Removal: Burial
Date: 17 October 1956
Name of Cemetery or Crematory: Gayheart Cemetery
Location: Softshell, Ky.
Date received by local registrar: 20 October 1956
Registrar's Signature: Myrtle Slone
Funeral director & address: Eastin Richey, Mt.
Sterling, Ky., John N. Taul
Transcribed by Debbie Tamborski, 25 April 2012 |