Date: 16 January 1950
Cert: 01121
Place of Death: County: Knott
City or Town: Lackey, Ky.
Length of stay (in this place): (blank)
Name of Hospital or Institution: Stumbo Memo. (illegible)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Raven Street
Address: Ky.
Full Name: Monnie GIBSON
Date of Death: 16 January 1950
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 24 March 1925
Age: 24 years
Usual Occupation: Housewife
Kind of Industry or business: (blank)
Birthplace: Knott Co., Ky.
Father's Name: Sherman SLONE
Mother's Maiden Name: Virgie NICHOLS
Was deceased ever in armed forces: (blank)
Social Security No.: None
Informant: Sherman SLONE
Disease or condition directly leading to death:
Bilateral Lobular Pneumonia
Interval between onset and death: (blank)
Due to (b): Post operative following Hysterectomy
Interval between onset and death: 03 days
Due to (c): Chronic Endometritis
Interval between onset and death: (blank)
Other significant conditions: Uremia (illegible)
Date of Operation: (blank)
Major findings of operation: Chronic Endometritis
Autopsy: (blank)
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 01 January 1950
to 16 January 1950, that I last saw the deceased alive on 16
January 1950, and that death occurred at 2:30 p.m., from the
causes and on the date stated above.
Date signed: (illegible) January 1950
Address: Stumbo Hospital, Lackey, Ky.
Signature: John M. Byrne, M.D.
Burial, Cremation or Removal: Burial
Date: 18 January 1950
Name of Cemetery or Crematory: Family
Location: Knott Co., Ky.
Date received by local registrar: 19 January 1950
Registrar's Signature: Rose B. Craft
Funeral director & address: Hindman Funeral
Home By John N. Taul
Transcribed by Debbie Tamborski, 13 January 2011 |