Date: 18 August 1953
Cert: 26620
Place of Death: County: Knott City or Town: Hall,
Ky. - Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Hall, Ky.
Full Name: Cleveland HALL
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: 13 April 1938
Age: 15 years, 04 months, 05 days
Birthplace: Halo, Ky.
Occupation: Student
Industry or business: (blank)
Father Name: Bill Hall
Father Birthplace: Hall, Ky.
Mother Maiden Name: Sarah Jane HOLBROOK
Mother Birthplace: Puncheon, Ky.
Informant: Bill Hall, Hall, Ky.
Burial Place: Hall, Ky.
Date: 20 August 1953
Signature of funeral director: (illegible) Banks, Craft
Funeral Home, May, Ky.
Date received by local registrar: 23 June 1955
Registrar's Signature: Myrtle Slone
Date of Death: 18 August 1953
I hereby certify that I attended deceased from 18 August 1953
to 18 August 1953, that I last saw him alive on 1:20 a.m., and
that death occurred on the date stated above at (blank)
Immediate cause of death: History leads one to believe
the pt. had a coronary attack
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: (illegible) Skaggs, M.D., Fleming, Ky.
Date signed: 13 August (illegible)
Transcribed by Debbie Tamborski, 24 February 2011 |