Date: 11 October 1952
Cert: 21729
Place of Death: County: Knott
City or Town: Rural
Length of stay (in this place): All of life
Street address or location: Hall, Ky.
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural If rural give
precinct: Hall, Ky.
Full Name: Roda GILLEM
Date of Death: 11 October 1952
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: unknown
Age: app. 72 years
Usual Occupation: Housewife
Kind of Industry or business: Keeping house
Birthplace: N. Carolina
Father's Name: Andy SLONE
Mother's Maiden Name: Luiza NAPIER
Was deceased ever in armed forces: No
Social Security No.: (blank)
Informant: Barney GILLEM
Disease or condition directly leading to death: Heart
Attack
Interval between onset and death: Sudden
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
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 (blank) to
(blank), that I last saw the deceased alive on (blank), and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: 11 October 1952
Address: Hindman, Ky.
Signature: Jno. N. Taul Coroner
Burial, Cremation or Removal: Burial
Date: 13 October 1952
Name of Cemetery or Crematory: Family Cemetery
Location: Hall, Ky.
Date received by local registrar: 14 October 1952
Registrar's Signature: Rose B. Craft
Funeral director & address: John N. Taul, Hindman,
Ky.
Transcribed by Debbie Tamborski, 24 January 2011 |