Date: 01 March 1944
Cert: 07539
Place of Death: County: Knott City or
Town: Emmalena, Ky.
Street Number or Location: Rural
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Emmalena, Ky.
Street No.: Rural
Full Name: Lorena GIBSON
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Widowed
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 31 July 1910
Age: 34 years, 06 months, 21 days
Birthplace: Ky.
Occupation: Housewife
Industry or business: (blank)
Father Name: Harlin GIBSON
Father Birthplace: Ky.
Mother Maiden Name: Martha STAMPER
Mother Birthplace: Ky.
Informant: Harlin GIBSON, Emmalena, Ky.
Burial Place: Combs Cemetery
Date: 02 March 1944
Signature of funeral director: Friends, Emmalena, Ky.
Date received by local registrar: 18 March 1944
Registrar's Signature: Ida Livingston
Date of Death: 01 March 1944
I hereby certify that I attended deceased from 10 January 1944 to
01 March 1944, that I last saw him alive on 29 February 1944, and that death
occurred on the date stated above at 8 p.m.
Immediate cause of death: Chronic Heart Disease
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. F. Kelley, M.D., Hindman, Ky.
Date signed: 17 March 1944
Transcribed by Debbie Tamborski, 12 November 2010 |