DEATH CERTIFICATE

ARNOLD GIBSON

Date  20 December 1940
Cert:  29237
Place of Death: County: Knott     City or Town: Bolen
Street number of Location:  Rural
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.    County: Knott
City or Town:  Bolen
Full Name:  Arnold GIBSON
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of:  (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased:  27 October 1940
Age: 01 months, 22 days
Birthplace:  Bolyn, Ky.
Occupation:  none
Industry or business: (blank)
Father Name:  Carew GIBSON
Father Birthplace:  Bolen, Ky.
Mother Maiden Name:  Marguerette GIBSON
Mother Birthplace:  Bolen, Ky.
Informant/Address:  Bill COLLINS
Burial Place:  Bolyn, Ky.
Date:  21 December 1940
Signature of funeral director/address: J. S. GIBSON, Bolyn, Ky.
Date received by local registrar:  29 December 1940
Registrar's Signature:  Macie Miller
Date of Death:  20 December 1940
I hereby certify that I attended deceased from 16 December 1940 to (blank), that I last saw him alive on (blank), and that death occurred on the date stated above at 1 a.m.
Immediate cause of death:  Pneumonia
Duration: (blank)
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: 8:45 - 19 December 1940
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: T. J. Chandler, M.D., Lackey, Ky.
Date signed:  21 December 1940
Transcribed by Debbie Tamborski, 17 August 2010