Date: 21 October 1951
Cert: 23001
Place of Death: County: Knott
City or Town: Sassasfrass
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky.
County: Letcher
City or Town: Premium Street Address:
(blank)
Full Name: Robert HARVEY
Date of Death: 21 October 1951
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 18 October 1895
Age: 56 years
Usual Occupation: Trucker
Kind of Industry or business: (blank)
Birthplace: Ky.
Father's Name: Henry HARVEY
Mother's Maiden Name: Mary Ellen HARVEY
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Mrs. Erie HARVEY
Disease or condition directly leading to death:
Fractured skull and internal injuries automobile accident
Interval between onset and death: (blank)
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
Accident, suicide, or homicide: accident
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: 21 October 1951, 11:30 p.m.
Injury occurred at work: Not while at work
How did injury occur: (blank)
I hereby certify that I attended deceased from 21 October 1951 to
21 October 1951, that I last saw the deceased alive on 21
October 1951, and
that death occurred at 11:30 p.m., from the causes and on the
date stated above.
Date signed: 26 October 1951
Address: Hazard, Ky.
Signature: (illegible) Coroner, Perry Co., Ky.
Burial, Cremation or Removal: Burial
Date: 23 October 1951
Name of Cemetery or Crematory: Family
Location: Letcher, Ky.
Date received by local registrar: 07 January 1951
Registrar's Signature: Rose B. Craft
Funeral director & address: Johnson Funeral Home, Hazard,
Ky.
Transcribed by Debbie Tamborski, 20 January 2011 |