|
DEATH
CERTIFICATE
IRVIN HALL
Date 26 July 1930
Cert: Original #18179 Duplicate
#20879
Place of Death: Voting Pct: Hazard
Hospital, Hazard, Perry Co., Ky.
Full Name: Irvin HALL
Residence: (blank)
Length of Residence in city where death occurred:
(blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Date of Birth: ? [sic] September 1923
Age: 07 years, 09 months, ? [sic] days
Occupation: at home
Birthplace: Knott Co., Ky.
Father Name: Joe HALL
Birthplace Father: Knott Co., Ky.
Mother Maiden Name: Martha REYNOLDS
Birthplace Mother: Letcher Co., Ky.
Informant/Address: Joe HALL, Cars fork, Ky.
Filed: 09 August 1930
Registrar: J. P. Boggs
Death of Date: 26 July 1930
I hereby certify that I attended deceased from 24 July 1930 to
26 July 1930, that I last saw him alive on 26 July 1930, and
that death occurred on the date stated above at 8:05 a.m.
Cause of Death: Acute Anterior Poliomyelitis
Duration: 10 days
Contributory: (blank)
Duration: (blank)
Where was disease contracted if not at place of death?:
(blank)
Did an operation precede death: no Date: (blank)
Was there an autopsy: no
What test confirmed diagnosis: (blank)
Signed/Address: J. E. Hagan, M.D., 28 July 1930 Hazard
Hosp., Hazard, Ky.
Place of Burial or Removal: Cars fork, Ky.
Date of Burial: 28 July 1930
Undertaker/Address: Ideal Furn. Co., Hazard, Ky.
Transcribed by Debbie Tamborski, 29 March 2010 |
|