Date:   22 April 1942
Cert:   09537 
Place of Death: County: Knott     City or Town: Mousie
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:  Mousie  Rural
Full Name:  Delmer Ray HICKS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of:  Amos HICKS age 29
Age of husband or wife if alive: Eva HICKS 25 years
Birth date of deceased:  22 April 1942 (transcribed as written)
Age: 10 days
Birthplace: Knott
Occupation:  (blank)
Industry or business: (blank)
Father Name:  Amos HICKS
Father Birthplace:  Knott
Mother Maiden Name:  Eva HICKS
Mother Birthplace:  Knott
Informant:  Mertie HICKS, Mousie, Ky.
Burial Place:  (blank)
Date:  (blank)
Signature of funeral director: (blank)
Date received by local registrar:  Ida Livingston
Registrar's Signature:  28 April 1942
Date of Death:  22 April 1942
I hereby certify that I attended deceased from 12 April 1942 to 22 April 1942, that I last saw h-- alive on 22 1942, and that death occurred on the date stated above at 3:30 p.m.
Immediate cause of death:  Pneumonia
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: Mertie Hicks, Mousie
Date signed:  26 1942
Transcribed by Debbie Tamborski, 17 October 2010