Date: 30 September 1942
Cert: 01853
Place of Death: County: Knott City or
Town: Lackey
Name of Hospital or Institution: Stumbo Mem. Hosp.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Floyd
City or Town: Garrett
Full Name: Rondle GRIFFITH
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 15 September 1940
Age: 02 years, 15 days
Birthplace: Garrett, Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Richard GRIFFITH
Father Birthplace: Floyd Co., Ky.
Mother Maiden Name: (illegible)
Mother Birthplace: (blank)
Informant: R. R. GRIFFITH, Garrett, Ky.
Burial Place: Garrett, Ky.
Date: 01 October 1942
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: 05 January 1943
Registrar's Signature: Ida Livingston
Date of Death: 30 September 1942
I hereby certify that I attended deceased from 29 September
1942 to
30 September 1942, that I last saw him alive on 30 September
1942, and that death occurred on the date stated above at
10:30 p.m.
Immediate cause of death: Dyptheria
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: C. J. Kelso, M.D.
Date signed: (blank)
Transcribed by Debbie Tamborski, 17 October 2010 |