|
DEATH
CERTIFICATE
TROY HALE JR.
Date 17 August 1940
Cert: 19753
Place of Death: County: Knott Co. City or Town:
Lackey, Ky.
Name of Hospital or Institution: Stumbo Memorial Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Floyd
City or Town: Weeksbury, Ky.
Full Name: Troy HALE Jr.
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: 26 January 1940
Age: 06 months, 22 days
Birthplace: Weeksbury, Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Troy HALE Sr.
Father Birthplace: Lawrence Co.
Mother Maiden Name: Thelma STANAFORD
Mother Birthplace: Johnson Co.
Informant/Address: Troy HALE Sr., Weeksbury, Ky.
Burial Place: Coons Camp, Ky.
Date: 18 August 1940
Signature of funeral director/address: G. D. Ryan, Martin, Ky.
Date received by local registrar: 27 August 1940
Registrar's Signature: Macie Miller
Date of Death: 17 August 1940
I hereby certify that I attended deceased from 26 July 1940 to
17 August 1940, that I last saw him alive on 17 August 1940,
and that death occurred on the date stated above at 1:05 a.m.
Immediate cause of death: Pneumonia
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: W. L. Stumbo, M.D., Martin, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 18 August 2010 |
|