Date: 07 October 1945
Cert: 21790
Place of Death: County: Knott City or
Town: Pinetop Rural
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: Pinetop Rural
Full Name: Liberty HAYES
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White,
Married
Husband or Wife of: Elizabeth HAYES
Age of husband or wife if alive: 65 years
Birth date of deceased: 10 February 1861
Age: 84 years, 07 months, 27 days
Birthplace: Knott Co., Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Anderson HAYES
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Rachel SIZEMORE
Mother Birthplace: Knott Co., Ky.
Informant: Troy HAYES, Gearheart, Ky.
Burial Place: Pinetop, Ky.
Date: 08 October 1945
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: 11 October 1945
Registrar's Signature: Rose B. Craft
Date of Death: 07 October 1945
I hereby certify that I attended deceased from 01 October 1945 to
07 October 1945, that I last saw him alive on 07 October 1945, and that death
occurred on the date stated above at 1:00 p.m.
Immediate cause of death: Chronic Cyrosis of the liver
and Disease of hart
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
Date signed: 11 October 1945
Transcribed by Debbie Tamborski, 28 November 2010 |