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DEATH
CERTIFICATE
SAM HOWARD
Date 17 May 1930
Cert: 12853
Place of Death: Voting Precinct: No. 10, Hazard, Perry Co.,
Ky.
Full Name: Sam HOWARD
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 03 March 1898
Age: 32 years, 02 months, 14 days
Occupation: Farmer
Birthplace: Knott Co., Ky.
Name of Father: Henry HOWARD
Birthplace Father: Breathitt
Maiden name of Mother: Amelia MOSLEY
Birthplace Mother: Knott
Informant/Address: Henry HOWARD, Hindman, Ky.
Filed: 10 June 1930
Registrar: J. P. Boggs
Death Date: 17 May 1930
I hereby certify that I attended deceased from 11 May 1930, to
17 May 1930, that I last saw him alive on 17 May 1930, and
that death occurred, on the date stated above at 6 a.m.
Cause of Death: Gunshot wounds
Duration: (blank)
Contributory: (blank)
Signed/Address: Taylor Hurst, MD, 20 May 1930, Hazard, Ky.
Length of residence at place of death: 06 days
Where was disease contracted if not at place of
death?: Hindman, Ky.
Place of Burial or Removal: Hindman, Ky.
Date of Burial: 18 May 1930
Undertaker/Address: G. W. Nicholson, Hazard, Ky.
Transcribed by Debbie Tamborski, 29 March 2010 |
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