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DEATH
CERTIFICATE
Mrs. ANDERSON HAYS
Date 24 July 1942
Cert: 16899
Place of Death: County: Perry City or Town:
Hazard
Hospital or Institution: Hazard Hospital Co.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Perry
City or Town: Ary Street No.:
Rural
Full Name: Mrs. Anderson HAYS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Anderson HAYS
Age of husband or wife if alive: (blank)
Birth date of deceased: 04 March 1867
Age: 75 years
Birthplace: Knott Co., Ky.
Occupation: Housewife
Industry or business: (blank)
Father Name: William MAGGARD
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Amanda COBURN
Mother Birthplace: Floyd Co., Ky.
Informant: Bill HAYES, Irvine, Ky.
Burial Place: Ary
Date: 26 July 1942
Signature of funeral director: Engles, Hazard, Ky.
Date received by local registrar: 27 July 1942
Registrar's Signature: Anna Laura Boulos
Date of Death: 24 July 1942
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 4 a.m.
Immediate cause of death: Cerebral hemorrhage
(illegible)
Duration: 11 days
Due to: Hypertension Duration:
11 years
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: 27 July 1942
Transcribed by Debbie Tamborski, 25 May 2010 |
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