Date: 09 September 1945
Cert: 21792
Place of Death: County: Knott City or
Town: Lackey Rural
Name of Hospital or Institution: Stumbo Mem. Hosp.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Raven
Full Name: Margaret GIBSON
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Miles M. GIBSON
Age of husband or wife if alive: 77 years
Birth date of deceased: 04 April 1869
Age: 76 years, 04 months, 29 days
Birthplace: Knott Co., Ky.
Occupation: Housewife
Industry or business: (blank)
Father Name: Plessy SLONE
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: ADKINS
Mother Birthplace: Knott Co., Ky.
Informant: Ben FRANKLIN, Wayland, Ky.
Burial Place: Raven, Ky.
Date: 12 September 1945
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: 05 October 1945
Registrar's Signature: Rose B. Craft
Date of Death: 09 September 1945
I hereby certify that I attended deceased from 26 August 1945 to
09 September 1945, that I last saw him alive on 09 September
1945, and that death
occurred on the date stated above at 10:00 p.m.
Immediate cause of death: Lobar Pneumonia Hypertension
(illegible)
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: J. H. Stumbo, M.D., Lackey, Ky.
Date signed: 05 October 1945
Transcribed by Debbie Tamborski, 27 November 2010 |