|
DEATH
CERTIFICATE
BELLE HONECKER
Date 25 September 1940
Cert: 24241
Place of Death: County: Knott City or Town:
Lackey
Name of Hospital or Institution: Stumbo Memorial Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Floyd
City or Town: Tram, Ky.
Full Name: Belle HONECKER
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: George HONECKER
Age of husband or wife if alive: 53 years
Birth date of deceased: 15 December 1899
Age: 40 years, 09 months, 10 days
Birthplace: Tram, Ky.
Occupation: Domestic
Industry or business: (blank)
Father Name: William (?RAMEY? illegible)
Father Birthplace: Tennessee
Mother Maiden Name: Mallie BANNER
Mother Birthplace: Floyd Co.
Informant/Address: George Honecker, Tram, Ky.
Burial Place: Tram, Ky.
Date: 27 September 1940
Signature of funeral director/address: G. D. Ryan, Martin, Ky.
Date received by local registrar: 15 October 1940
Registrar's Signature: Macie Miller
Date of Death: 25 September 1940
I hereby certify that I attended deceased from 23 September
1940 to
25 September 1940, that I last saw him alive on 25 September
1940, and that death occurred on the date stated above at 3:00
a.m.
Immediate cause of death: Carcinoma of breast
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: W. L. Stumbo, M.D., Lackey, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 18 August 2010 |
|