Date: 29 September 1949
Cert: 21238
Place of Death: County: Knott
City or Town: Hindman Rural
Length of stay (in this place): (blank)
Name of Hospital or Institution: None
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Hindman Rural Street Address:
(blank)
Full Name: (Not Named) GAYHEART
Date of Death: 29 September 1949
Sex, Color or Race, Marital Status: Male, White, Never Married
Date of Birth: 29 September 1949
Age: 15 minutes
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Hindman, Ky. Rural
Father's Name: Sid GAYHEART
Mother's Maiden Name: Diana HALL
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Sid GAYHEART
Disease/condition directly leading to death:
Congestion of the lungs
Interval between onset and death: (blank)
Due to: undeveloped growth
Other significant conditions: (blank)
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 29 September
1949 to
29 September 1949, that I last saw the deceased alive on 29
September 1949, and
that death occurred at 2:15 a.m., from the causes and on the
date stated above.
Date signed: 15 October 1949
Address: Hindman, Ky.
Signature: M. F. Kelley, M.D.
Burial, Cremation or Removal: Burial
Date: 29 September 1949
Name of Cemetery or Crematory: Family Cem.
Location: Leburn, Knott, Ky.
Date received by local registrar: 15 October 1949
Registrar's Signature: Rose B. Craft
Funeral director & address: Family & Friends,
Hindman, Ky.
Transcribed by Debbie Tamborski, 04 January 2011 |