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DEATH
CERTIFICATE
E. L. JOHNSON
Date: 05 October 1953
Cert: 20310
Place of Death: County: Floyd City or Town:
Hi Hat
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky. County:
Floyd
City or Town: Hi Hat Street Address: (blank)
Full Name: E. L. JOHNSON
Date of Death: 05 October 1953
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 14 June 1883
Age: 70 years
Usual Occupation: Miner
Kind of Industry or business: Mining
Birthplace: Knott Co.
Father's Name: John JOHNSON
Mother's Maiden Name: Rhoda MARTIN
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Henry JOHNSON
Disease/condition directly leading to death: Coronary
embolism
Interval between onset and death: (blank)
Due to: Lobar pneumonia
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
Accident, suicide, or homicide: (blank)
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 01 October 1953 to
05 October 1953, that I last saw the deceased alive on 04
October 1953, and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: 15 October 1953
Address: Wheelwright, Ky.
Signature: J. W. Bailey, M.D.
Burial, Cremation or Removal: Burial
Date: 07 October 1953
Name of Cemetery or Crematory: Buckingham
Location: Buckingham, Ky.
Date received by local registrar: 19 October 1953
Registrar's Signature: Lucy Ransdell
Funeral director & address: Hall Bros., Martin, Ky.
Transcribed by Debbie Tamborski, 13 August 2010 |
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