Date: 04 August 1947
Cert: 20403
Place of Death: County: Knott City or
Town: Pippapass, Ky.
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Pippapass
Full Name: Jess GIBSON
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White,
Married
Husband or Wife of: Dora B. GIBSON
Age of husband or wife if alive: 70 years
Birth date of deceased: Don't know
Age: 72 years
Birthplace: Raven (Knott Co.)
Occupation: Farmer
Industry or business: (blank)
Father Name: Hiram GIBSON
Father Birthplace: Raven, Ky.
Mother Maiden Name: Margrett HOLBROOK
Mother Birthplace: Raven
Informant: Odus GIBSON, Raven
Burial Place: Raven
Date: 06 August 1947
Signature of funeral director: G. D. Ryan, Martin, Ky.
Date received by local registrar: 13 September 1947
Registrar's Signature: Rose B. Craft
Date of Death: 04 August 1947
I hereby certify that I attended deceased from 04 July 1947 to
04 August 1947, that I last saw him alive on 04 August 1947,
and that death occurred on the date stated above at 1 a.m.
Immediate cause of death: Pneumonia
Duration: (blank)
Due to: Paralysis
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: J. W. Duke, M.D., Hindman, Ky.
Date signed: 13 September 1947
Transcribed by Debbie Tamborski, 17 December 2010 |