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DEATH
CERTIFICATE
HAROLD HALL
Date 07 February 1940
Cert: 03758
Place of Death: County: Floyd City or Town:
Martin, Ky.
Name of Hospital or Institution: Beaver Valley Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Floyd
City or Town: Weeksberry, Ky.
Full Name: Harold 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: 10 December
Age: 02 years, 01 months, 28 days
Birthplace: Knott Co.
Occupation: (blank)
Industry or business: (blank)
Father Name: Prinntable HALL
Father Birthplace: Knott Co.
Mother Maiden Name: Jane FOUCH
Mother Birthplace: Knott
Informant: Printable HALL, Weeksberry, Ky.
Burial Place: Hall, Ky.
Date: 08 February 1940
Signature of funeral director: G. D. Ryan, Martin, Ky.
Date received by local registrar: 08 February 1940
Registrar's Signature: Mrs. Ben Norris
Date of Death: 07 February 1940
I hereby certify that I attended deceased from 05 February
1940 to
07 February 1940, that I last saw him alive on (blank), and
that death occurred on the date stated above at 5:00 p.m.
Immediate cause of death: Acute Lymphatic Leukemia
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: A. Rabin, M.D., Martin
Date signed: (blank)
Transcribed by Debbie Tamborski, 10 May 2010 |
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