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DEATH
CERTIFICATE
THOMAS HURT
Date: 20 August 1950
Cert: 17099
Place of Death: County: Perry City or Town:
Ary
Length of stay (in this place): (blank)
Name of Hospital or Institution: Homeplace Hospital
Usual Residence of Deceased: State: Ky. County:
Breathitt
City or Town: Hardshell Street Address: (blank)
Full Name: Thomas HURT
Date of Death: 20 August 1950
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 16 August 1895
Age: 55 years
Usual Occupation: Retired Miner
Kind of Industry or business: Mines
Birthplace: Knott County, Ky.
Father's Name: Unknown
Mother's Maiden Name: Celia HURT
Was deceased ever in armed forces: no
Social Security No.: 404-01-5645
Informant: Mrs. Elizabeth HURT
Disease or condition directly leading to death:
Intracranial Hemorrhage
Interval between onset and death: 12 hours
Due to: Gunshot wounds of brain
Interval between onset and death: 12 hours
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: no
Accident, suicide, or homicide: gunshot wound
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 20 August 1950 to
20 August 1950, that I last saw the deceased alive on 20
August 1950, and
that death occurred at 11:40 p.m., from the causes and on the
date stated above.
Date signed: 21 August 1950
Address: Homeplace, Ary, Ky.
Signature: Paul E. Adolph, M.D.
Burial, Cremation or Removal: Burial
Date: 22 August 1950
Name of Cemetery or Crematory: Trace Branch Cemetery
Location: Dwarf, Ky.
Date received by local registrar: 24 August 1950
Registrar's Signature: Georgia Pendleton
Funeral director & address: Maggard & Garrett,
Hazard, Ky.
Transcribed by Debbie Tamborski, 15 July 2010 |
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