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DEATH
CERTIFICATE
MOLLIE ALBERTA HURST
Date 24 January 1941
Cert: 03600
Place of Death: County: Wolfe City or Town:
Malaga
Street No. or Location: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky County:
Wolfe
City or Town: Malaga Street No.:
13
Full Name: Mollie Alberta HURST
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: John N. HURST
Age of husband or wife if alive: 63 years
Birth date of deceased: 15 December 1887
Age: 54 years, 03 months, 08 days
Birthplace: Knott Co., Kentucky
Occupation: Housewife
Industry or business: (blank)
Father Name: Thomas KELLY
Father Birthplace: Kentucky
Mother Maiden Name: Minerva YOUNG
Mother Birthplace: Kentucky
Informant: Foster HURST, Malaga, Ky.
Burial Place: Breathitt Co.
Date: 27 January 1941
Signature of funeral director: L. Porter Ray, Jackson, Ky.
Date received by local registrar: (blank)
Registrar's Signature: (blank)
Date of Death: 24 January 1941
I hereby certify that I attended deceased from 24 January 1941 to
24 January 1941, that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Leakage of Heart, Heart failure
Duration: 03 years
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: James H. Durn, M.D., Campton
Date signed: 02 February 1941
Transcribed by Debbie Tamborski, 13 May 2010 |
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