Date: 16 October 1945
Cert: 21794
Place of Death: County: Knott City or
Town: Lackey
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Lackey Rural
Full Name: John HALL
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White,
Married
Husband or Wife of: (illegible ?Elhull?) HALL
Age of husband or wife if alive: 38 years
Birth date of deceased: (blank)
Age: 31 years
Birthplace: Harold
Occupation: Miner
Industry or business: Coal
Father Name: Monroe HALL
Father Birthplace: Ky.
Mother Maiden Name: Lula COLLINS
Mother Birthplace: Ky.
Informant: (blank)
Burial Place: Lackey
Date: 18 October 1945
Signature of funeral director: E. P. Arnold,
Prestonsburg
Date received by local registrar: 27 October 1945
Registrar's Signature: Rose B. Craft
Date of Death: 16 October 1945
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 (blank)
Immediate cause of death: Crushed skull cause unknown
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: J. A. Stumbo, M.D., Lackey, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 27 November 2010 |