Date: 11 November 1941
Cert: 29459
Place of Death: County: Knott City or
Town: Sassafras
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Perry
City or Town: Vicco Street No.
or precinct: No. 42
Full Name: William F. HOLLIMAN
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Widowed
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 25 May 1860
Age: 81 years, 06 months, 17 days
Birthplace: Louisville, Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Frank NICKLES
Father Birthplace: Ireland
Mother Maiden Name: Lucy ? (transcribed as written)
Mother Birthplace: Ireland
Informant: Rufus HOLLIMAN, Vicco, Ky.
Burial Place: Cornett Hill, Knott Co.
Date: 10 November 1941 (transcribed as written)
Signature of funeral director: Engle Und.
& Hdwe. Co., Hazard, Ky.
Date received by local registrar: 01 December 1941
Registrar's Signature: Anna Laura Boulos
Date of Death: 11 November 1941
I hereby certify that I attended deceased from 10 September
1941 to
11 November 1941, that I last saw him alive on 05 November
1941, and that death occurred on the date stated above at 10
a.m.
Immediate cause of death: Dropsy
Duration: 03 months
Due to: Cardiac Renal Disease
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: A. B. Pigman, Allock, Ky.
Date signed: 01 December 1941
Transcribed by Debbie Tamborski, 12 October 2010 |