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DEATH
CERTIFICATE
Mrs. CHLOIE GILLIAM
Date 17 November 1936
Cert: 30597
Place of Death: Voting Pct.: Jenkins Hospital, Jenkins,
Letcher Co., Ky.
Full Name: Mrs. Chloie GILLIAM
Residence: 1725 Chopping Branch
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Hess GILLIAM
Date of Birth: 17 November 1893
Age: 43 years
Occupation: Housewife
Birthplace: Knott Co., Ky.
Father Name: John COMBS
Birthplace Father: Perry Co., Ky.
Mother Maiden Name: Elizabeth RITCHIE
Birthplace Mother: Perry Co., Ky.
Informant/Address: Hess GILLIAM, McRoberts, Ky.
Burial Cremation Removal Place: Sassafras, Ky.
Date: 19 November 1936
Undertaker/Address: Geo. W. McCoy, Jenkins, Ky.
Filed: 10 December 1936
Registrar: (illegible ??egan)
Death of Date: 17 November 1936
I hereby certify, That I attended deceased from 10 November
1936 to
17 November 1936, that I last saw her alive on 10 November
1936, death is said
to have occurred on the date stated above, at 5:05 p.m.
Cause of Death: Myocardial failure - post operative
Date of onset: (blank)
Contributory causes: Endometri??? with repeated hemorrhage
Name of operation: (blank)
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: (blank)
Signed/Address: Leon O. Spencer, M.D., Jenkins, Ky.
Transcribed by Debbie Tamborski, 18 April 2010 |
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