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DEATH
CERTIFICATE
WILLARD HALL
Date 15 December 1942
Cert: 02268
Place of Death: County: Perry City or Town:
Hazard
Street No. or Location: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Perry
City or Town: Rural If Rural
give Precinct: Lothair, Ky.
Full Name: Willard HALL
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Kathleene HALL
Age of husband or wife if alive: 30 years
Birth date of deceased: 1910
Age: 31 years
Birthplace: Knott Co., Ky.
Occupation: Coal Miner
Industry or business: (blank)
Father Name: Joe HALL
Father Birthplace: Knott Co.
Mother Maiden Name: Dora NIECE
Mother Birthplace: Letcher Co., Ky.
Informant: Joe HALL, Lothair
Burial Place: Englewood
Date: 17 December 1942
Signature of funeral director: Engle Und. &
Hdwe. Co., Hazard, Ky.
Date received by local registrar: 01 January 1943
Registrar's Signature: A. L. Boulos
Date of Death: 15 December 1942
I hereby certify that I attended deceased from 31 October 1942 to
15 December 1942, that I last saw him alive on 15 December
1942, and that death
occurred on the date stated above at 5:30 p.m.
Immediate cause of death: Cerebral hemorrhage
Duration: (illegible)
Due to: Malignant Hypertension Duration:
(illegible)
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: Chris S. Jackson, M.D., Hazard,
Ky.
Date signed: 18 December 1942
Transcribed by Debbie Tamborski, 25 May 2010 |
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