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DEATH
CERTIFICATE
ANDY J. HICKS
Date 19 April 1940
Cert: 09541
Place of Death: County: Floyd City or Town:
Garrett, Ky.
Name of Hospital or Institution: on hiway [sic]
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Floyd
City or Town: Garrett, Ky.
Street No.: Rural
Full Name: Andy J. HICKS
If Veteran Name War: (blank)
Social Security No.: 403-01-8118
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Eva HICKS
Age of husband or wife if alive: 32 years
Birth date of deceased: 10 June 1898
Age: 41 years, 10 months, 09 days
Birthplace: Knott Co.
Occupation: Miner
Industry or business: (blank)
Father Name: Alexander HICKS
Father Birthplace: Knott Co.
Mother Maiden Name: Susan SHEPARD
Mother Birthplace: Knott Co.
Informant: Eva HICKS, Lackey, Ky.
Burial Place: Garrett, Ky.
Date: 21 April 1940
Signature of funeral director: G. D. Ryan, Martin, Ky.
Date received by local registrar: 29 April 1940
Registrar's Signature: Mrs. Ben Norris
Date of Death: 19 April 1940
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw h-- alive on 19 April 1940, and that
death occurred on the date stated above at 10:00 p.m.
Immediate cause of death: Crushed skull, broken legs
Duration: (blank)
Due to: Car hitting him on hiway [sic]
Major findings of operations: (blank)
Accident, suicide, or homicide: Accident
Date of occurrence: 19 April 1940
Where did injury occur: Public Hiway [sic]
While at work: No
Means of injury: Crushed skull
Signature & Address: W. J. Ryan, Undertaker, Martin,
Ky.
Date signed: 29 April 1940
Transcribed by Debbie Tamborski, 10 May 2010 |
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