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DEATH
CERTIFICATE
ANDY J. HICKS
Date 19 April 1940
Cert: 24770
Place of Death: County: Knott City or Town: Lackey, Ky.,
Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Floyd
City or Town: Lackey
Full Name: Andy J. HICKS
If Veteran Name War: (blank)
Social Security No.: 403-01-8918
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Eva HICKS
Age of husband or wife if alive: 33 years when husband
died
Birth date of deceased: 16 July 1898
Age: 41 years, 09 months, 03 days
Birthplace: Knott Co., Ky.
Occupation: Mine work
Industry or business: Laid track in mines
Father Name: Alexander HICKS
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Susanna SHEPHERD
Mother Birthplace: Knott Co., Ky.
Informant/Address: Eva HICKS, Lackey, Ky.
Burial Place: Tom Martin Cem., Garrett, Ky.
Date: 21 April 1940
Signature of funeral director/address: (blank)
Date received by local registrar: 16 November 1941
Registrar's Signature: Rose B. Craft per L. Roth
Date of Death: 19 April 1940
I hereby certify that I attended deceased from 19 April 1940 to
19 April 1940, that I last saw him alive on 19 April 1940, and that death
occurred on the date stated above at 11 p.m.
Immediate cause of death: Run down by an automobile
Duration: (blank)
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: Accident
Date of occurrence: 19 April 1940
Where did injury occur: Highway No. 80
While at work: No
Means of injury: Car
Signature & Address: J. W. Duke, M.D.
Date signed: (blank)
Transcribed by Debbie Tamborski, 18 August 2010 |
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