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DEATH
CERTIFICATE
ORVILL GAYHEART
Date 08 October 1933
Cert: 24746
Place of Death: Voting Pct.: No. 35, Hurst & Snyder
Hospital, Hazard, Perry Co., Ky.
Full Name: Orvill GAYHEART
Residence: Vest, Ky.
Length of Residence: (life--crossed through)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: Single
Date of Birth: 03 November 1915
Age: 17 years, 11 months, 05 days
Occupation: Farmer
Birthplace: Vest, Knott County, Ky.
Father Name: Jim GAYHEART
Birthplace Father: Knott County, Ky.
Mother Maiden Name: Cora GAYHEART
Birthplace Mother: Knott County, Ky.
Informant/Address: Jim GAYHEART, Vest, Ky.
Burial Cremation Removal Place: Burial - Hindman
Date: 09 October 1933
Undertaker/Address: H. Engle, Hazard, Ky.
Filed: 10 October 1933
Registrar: J. P. Boggs
Death of Date: 08 October 1933
I hereby certify, That I attended deceased from 02 October
1933 to
07 October 1933, that I last saw him alive on 07 October 1933, death is said
to have occurred on the date stated above, at 8:04 a.m.
Cause of Death: Gunshot wound abdomen while (illegible)
Date of onset: (blank)
Contributory causes: (blank)
Name of operation: (blank)
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: (blank)
Signed/Address: Taylor Hurst, Hazard, Ky.
Transcribed by Debbie Tamborski, 02 April 2010 |
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