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DEATH
CERTIFICATE
LYDA GRIGSBY
Date: 03 December 1945
Cert: 27151
Place of Death: County: Perry City or Town:
Hazard
Hospital or Institution: Hazard Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Perry
City or Town: Lotts Creek
Full Name: Lyda GRIGSBY
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: John GRIGSBY
Age of husband or wife if alive: 45 years
Birth date of deceased: 29 September 1905
Age: 40 years, 02 months, 04 days
Birthplace: Knott Co.
Occupation: House wife
Industry or business: (blank)
Father Name: Ballard SMITH
Father Birthplace: Knott Co.
Mother Maiden Name: Annie SMITH
Mother Birthplace: Knott Co.
Informant: John GRIGSBY, Lotts Creek
Burial Place: Perry Co.
Date: 05 December 1945
Signature of funeral director: Wm. Engle, Jr., Hazard, Ky.
Date received by local registrar: 08 December 1945
Registrar's Signature: Opsie J. Deaton
Date of Death: 03 December 1945
I hereby certify that I attended deceased from 05 December
1945 to
05 December 1945, that I last saw him alive on 07 December
1945, and that death
occurred on the date stated above at (blank) [sic]
Immediate cause of death: Pneumonia Lobar
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: Dr. C. B. Combs, M.D., Hazard
Date signed: 08 December 1945
Transcribed by Debbie Tamborski, 05 June 2010 |
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