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DEATH
CERTIFICATE
GEORGIA C.
JOHNSON
Date: 22 December 1949
Cert: 26404
Place of Death: County: Perry City or Town:
Hazard
Length of stay (in this place):
Name of Hospital or Institution: Mount Mary Hospital
Usual Residence of Deceased: State: Kentucky County:
Perry
City or Town: Hazard Street Address: (blank)
Full Name: Georgia C. JOHNSON
Date of Death: 22 December 1949
Sex, Color or Race, Marital Status: Female, White,
Married
Date of Birth: 30 January 1902
Age: 47 years
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Knott County, Ky.
Father's Name: William S. COMBS
Mother's Maiden Name: Ella FLELCHE
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: (blank)
Disease or condition directly leading to death:
Carcinomatosis
Due to: Cancer of Uterus
Interval between onset & death: Unknown to 22 December 1949
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: Yes
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 13 December
1949 to
22 December 1949, that I last saw the deceased alive on 22
December 1949, and
that death occurred at 4:25 p.m., from the causes and on the
date stated above.
Date signed: 23 December 1949
Address: Hazard, Ky.
Signature: Martin Palmer, M.D.
Burial, Cremation or Removal: Burial
Date: 23 December 1949
Name of Cemetery or Crematory: Englewood
Location: Perry Co., Ky.
Date received by local registrar: 29 December 1949
Registrar's Signature: Georgia Pendleton
Funeral director & address: Engle's, Hazard, Ky.
Transcribed by Debbie Tamborski, 12 July 2010 |
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