Date: 21 February 1942
Cert: 09531
Place of Death: County: Knott City or
Town: Softshell
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Softshell
Full Name: Lewis GAYHEART
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Nealy GAYHEART
Age of husband or wife if alive: 36 years
Birth date of deceased: 20 March 1900
Age: 41 years, 09 months, 01 days
Birthplace: Knott Co., Ky.
Occupation: Merchant
Industry or business: (blank)
Father Name: Lee GAYHEART
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Lain COMBS
Mother Birthplace: Knott Co., Ky.
Informant: Essie GAYHEART, Soft Shell, KY.
Burial Place: Wiley Fork
Date: 22 February 1942
Signature of funeral director: E. H. Howard, Lackey, Ky.
Date received by local registrar: 21 April 1942
Registrar's Signature: Ida Livingston
Date of Death: 21 February 1942
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Heart attack
Duration: (blank)
Due to: Unknown cause, fell dead while at work, probably
overwork
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: J. W. Duke, M.D., Hindman, Ky.
Date signed: 21 April 1942
Transcribed by Debbie Tamborski, 17 October 2010 |