Date: 10 November 1941
Cert: 29458
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: Weeksberry, Ky.
Full Name: Cyntha Ann 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: 13 July 1940
Age: 01 years, 03 months, 27 days
Birthplace: Weeksberry, Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Sun HALL
Father Birthplace: W. Va.
Mother Maiden Name: Louise BURKS
Mother Birthplace: Pike Co.
Informant: Sun HALL, Weeksberry, Ky.
Burial Place: Weeksberry, Ky.
Date: 11 November 1941
Signature of funeral director: O. T. Lemaster, Martin, Ky.
Date received by local registrar: (blank)
Registrar's Signature: (blank)
Date of Death: 10 November 1941
I hereby certify that I attended deceased from 08 November
1941 to
10 November 1941, that I last saw her alive on (blank), and
that death occurred on the date stated above at 8:45 a.m.
Immediate cause of death: Bronchopneumonia
Duration: 04 days
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: C. R. Messer, M.D.
Date signed: (blank)
Transcribed by Debbie Tamborski, 12 October 2010 |