|
DEATH
CERTIFICATE
DOUGLAS MCARTHUR HALL
Date 11 April 1944
Cert: Original # 09074
Place of Death: County: Floyd City or
Town: Martin
Name of Hospital or Institution: Beaver Valley
Length of stay in hospital or community:
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Dry Creek, Ky.
Full Name: Douglas McArthur 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: 16 March 1944
Age: 26 days
Birthplace: Knott Co., Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Jesse HALL
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Pina Mae LITTLE
Mother Birthplace: Floyd Co., Ky.
Informant: Jesse HALL, Dry Creek, Ky.
Burial Place: Drift, Ky.
Date: 12 April 1944
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: 29 April 1944
Registrar's Signature: Winifred Norris
Date of Death: 11 April 1944
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 2:00 p.m.
Immediate cause of death: Hydrocephalus
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: J. A. Stumbo, M.D., Martin, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 08 February 2010 |
|