Date: 20 November 1943
Cert: 15299
Place of Death: County: Knott City or
Town: Raven
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Raven
Full Name: Ben GIBSON
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Margaret CAUDILL GIBSON
Age of husband or wife if alive: (blank)
Birth date of deceased: 14 February 1870
Age: 73 years, 09 months, 06 days
Birthplace: Raven, Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Miles GIBSON
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Susan GIBSON
Mother Birthplace: Raven, Ky.
Informant: Beckham SLONE, Dema, Ky.
Burial Place: Raven, Ky.
Date: 21 November 1943
Signature of funeral director: J. C. Mosley, Raven, Ky.
Date received by local registrar: 04 April 1945
Registrar's Signature: Rose B. Craft, acting, per B.
Carns
Date of Death: 20 November 1943
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: Chronic Nephritis
Duration: (blank)
Due to: (blank)
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: M. V. Wicker, M.D., Wayland,
Ky.
Date signed: 04 April 1945
Transcribed by Debbie Tamborski, 23 October 2010 |