Date: 01 May 1947
Cert: 29173 (Note at
bottom of page--State Number Cert 6771 (1947))
Place of Death: County: Knott City or
Town: Pippapass, Ky. Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Pippapass Rural
Full Name: Anna Jean HALL
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Single
Husband or Wife of: Infant
Age of husband or wife if alive: (blank)
Birth date of deceased: 19 February 1947
Age: 02 months, 12 days
Birthplace: Pippapass, Ky.
Occupation: None
Industry or business: (blank)
Father Name: Homer HALL
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Beatrice SLONE
Mother Birthplace: Knott Co., Ky.
Informant: Mr. Homer HALL
Burial Place: Pippapass, Ky.
Date: 03 May 1947
Signature of funeral director: Regular Baptist,
Pippapass, Ky.
Date received by local registrar: 12 November 1948
Registrar's Signature: Rose B. Craft
Date of Death: 01 May 1947
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Parents say this child seemed
perfectly during the day and was found dead in bed the next
morning - Cause unknown
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: J. W. Duke, M.D., Hindman
Date signed: 12 November 1948
Transcribed by Debbie Tamborski, 17 December 2010 |