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DEATH
CERTIFICATE
DONA ELLEN HICKS
Date 08 October 1936
Cert: 26781
Place of Death: Voting Pct.: Beaver Valley Hospital,
Martin, Floyd Co., Ky.
Full Name: Dona Ellen HICKS
Residence: Garrett, Ky.
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Alfred HICKS
Date of Birth: 1886
Age: 50 years
Occupation: Housewife
Birthplace: Knott Co., Ky.
Father Name: Enoch BOLEN
Birthplace Father: Knott Co., Ky.
Mother Maiden Name: Jane MESER
Birthplace Mother: Tenn.
Informant/Address: Alfred HICKS, Garrett, Ky.
Burial Cremation Removal Place: Garrett, Ky.
Date: 10 October 1936
Undertaker/Address: Franklin N. Moore, Martin, Ky.
Filed: 08 October 1936
Registrar: W. M. Griffith
Death of Date: 08 October 1936
I hereby certify, That I attended deceased from 08 October
1936 to
08 October 1936, that I last saw her alive on 08 October 1936,
death is said to have occurred on the date stated above, at
3:55 p.m.
Cause of Death: Tetanus
Date of onset: 08 October 1936
Contributory causes: (blank)
Name of operation: (blank)
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: (blank)
Signed/Address: J. R. Allen, M.D., Martin, Ky.
Transcribed by Debbie Tamborski, 20 April 2010 |
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