Date: 11 October 1942
Cert: 27290
Place of Death: County: Knott City or
Town: Pippapass, Ky.
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Pipppass, Ky.
Full Name: Miles HALL
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Miles HALL
Age of husband or wife if alive: (blank)
Birth date of deceased: (blank)
Age: 64 years
Birthplace: Knott Co., Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Jeff HALL
Father Birthplace: Ky.
Mother Maiden Name: (blank)
Mother Birthplace: Ky.
Informant: Mrs. Miles HALL, Pippapass, Ky.
Burial Place: Hollybush, Ky.
Date: 2? October 1942
Signature of funeral director: (blank)
Date received by local registrar: November 1942
Registrar's Signature: Ida Livingston
Date of Death: 11 October 1942
I hereby certify that I attended deceased from 11 October 1942 to
12 October 1942, that I last saw him alive on 11 October 1942, and that death
occurred on the date stated above at 7 a.m.
Immediate cause of death: Disease of heart & lungs
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: M. F. Kelley, M.D., Hindman, Ky.
Date signed: 15 October 1942
Transcribed by Debbie Tamborski, 17 October 2010 |