Date: 01 July 1945
Cert: 15270
Place of Death: County: Knott City or
Town: Mousie, Ky. Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Mousie, Ky. Rural
Full Name: Gladys HAYS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 09 November 1915
Age: 29 years, 07 months, 22 days
Birthplace: Mousie, Knott Co., Ky.
Occupation: House wife
Industry or business: (blank)
Father Name: John R. HAYS
Father Birthplace: Mousie, Ky.
Mother Maiden Name: Nancy MOORE
Mother Birthplace: Soft Shell, Ky.
Informant: Nancy HAYS, Mousie
Burial Place: Mousie, Ky.
Date: 02 July 1945
Signature of funeral director: Friends & neighbors,
Mousie, Ky.
Date received by local registrar: 31 July 1945
Registrar's Signature: Rose B. Craft
Date of Death: 01 July 1945
I hereby certify that I attended deceased from 28 June 1945 to
30 June 1945, that I last saw him alive on 30 June 1945, and that death
occurred on the date stated above at 1:30 a.m.
Immediate cause of death: Pulmonary T.B.
Duration: 03 years
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: J. W. Duke, M.D., Hindman
Date signed: 31 July 1945
Transcribed by Debbie Tamborski, 28 November 2010 |