Date: 03 June 1955
Cert: #12143
Place of Death: County: Knott City or Town:
Carrie Rural
Length of stay (in this place): (blank)
Street Address or Location: Home
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Carrie Rural
Street Address: Rural
Full Name: Roach GAYHEART
Date of Death: 03 June 1955
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 18 July 1871
Age: 63 years, 10 months, 15 days
Usual Occupation: Farmer
Kind of Industry or business: Farm
Birthplace: Kentucky
Father's Name: Hood TURNER
Mother's Maiden Name: Kate GAYHEART
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Laura GAYHEART
Disease/condition directly leading to death: Coronary
thrombosis
Interval between onset and death: 15 minutes
Due to: Arteriosclerosis & Hypertension
Interval between onset and death: 17 years
Other significant conditions: Cerebrovascular injury, with rt.
hemiparesis
Interval between onset and death: 02 months
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (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 16 October 1947
to 26 May 1955, that I last saw the deceased alive on 26 May
1955, and that death occurred at (blank), from the causes and
on the date stated above.
Date signed: 06 June 1955
Address: Hindman, Kentucky
Signature: D. G. Barker, M.D.
Burial, Cremation or Removal: Burial
Date: 04 June 1955
Name of Cemetery or Crematory: Gayheart Cemetery
Location: Carrie, Knott, Ky.
Date received by local registrar: 14 June 1955
Registrar's Signature: Myrtle Slone
Funeral director & address: Engle Funeral Home, Hazard,
Ky., Wm. Engle, Jr.
Transcribed by Debbie Tamborski, 14 May 2011 |