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DEATH
CERTIFICATE
JOHN HICKS
Date 22 May 1921
Cert: 10749
Place of Death: Voting Precinct: Lyon No. 8, Lawrence Co., Ky.
Full Name: John HICKS
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 20 August 1850
Age: 70 years
Occupation: Farmer
Birthplace: Knott Co., Ky.
Name of Father: John HICKS
Birthplace Father: Kentucky
Maiden name of Mother: Chairty HICKS
Birthplace Mother: Kentucky
Informant/Address: A. J. KELLEY, Martha, Ky.
Filed: 24 May 1921
Registrar: M. L. Collier
Death Date: 22 May 1921 at 8:30 p.m.
I hereby certify that I attended deceased from 20 May 1921, to
22 May 1921, that I last saw him alive on 22 May 1921, and
that death occurred, on the date stated above, at 8:30 p.m.
Cause of Death: Heart failure said he had been troubled
with same for years
Duration: (blank)
Contributory: (blank)
Signed/Address: N. T. Rice, M.D., 24 May 1921, Martha,
Ky.
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: Kelley Cemetery
Date of Burial: 25 May 1921
Undertaker/Address: Jackson Kelley, Martha, Ky.
Transcribed by Debbie Tamborski, 07 March 2010 |
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