Date: 14 January 1942
Cert: 01762
Place of Death: County: Knott City or
Town: Lackey, Ky.
Name of Hospital or Institution: Stumbo Mem.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Magoffin
City or Town: Gunlock, Ky.
Full Name: Wilburn HALE
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: 30 November 1921
Age: 20 years, 01 months, 20 days
Birthplace: Magoffin Co., Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Green HALE
Father Birthplace: Magoffin Co., Ky.
Mother Maiden Name: (illegible) Sissie SHEPARD
Mother Birthplace: Magoffin Co., Ky.
Informant: Jimmy SHEPARD, Gunlock, Ky.
Burial Place: Gunlock, Ky.
Date: 15 January 1942
Signature of funeral director: O. T. Lemaster, Martin, Ky.
Date received by local registrar: 05 February 1942
Registrar's Signature: Ida Livingston
Date of Death: 14 January 1942
I hereby certify that I attended deceased from 14 January 1942 to
14 January 1942, that I last saw him alive on 14 January 1942,
and that death occurred on the date stated above at 4:00 p.m.
Immediate cause of death: Diabetic coma
Duration: 04 days
Due to: Diabetes mellitus
Duration: years
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. R. Messer, M.D., Lackey, Ky.
Date signed: 04 February 1942
Transcribed by Debbie Tamborski, 17 October 2010 |