Date: 24 April 1946
Cert: 11628
Place of Death: County: Knott City or
Town: Leburn, Knott Co., Ky.
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: Leburn, Knott Co., Ky.
Full Name: Clara Nan HALL
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 25 January 1944
Age: 02 years, 02 months, 30 days
Birthplace: Virginia
Occupation: (blank)
Industry or business: (blank)
Father Name: Russel HALL
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Mildred PRATT
Mother Birthplace: Knott Co., Ky.
Informant: Russell HALL, Hindman, Ky.
Burial Place: Leburn, Ky.
Date: 25 April 1946
Signature of funeral director: Maggard, Hazard, Ky.
Date received by local registrar: 23 May 1946
Registrar's Signature: Mrs. Rose B. Craft
Date of Death: 24 April 1946
I hereby certify that I attended deceased from 20 April 1946 to
23 April 1946, that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Aplastic anemia
Duration: (blank)
Due to: cause ? (transcribed as written)
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: Lon C. Hall, Paintsville, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 07 December 2010 |