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DEATH
CERTIFICATE
JANE (COOK) JOHNSON
Date: 02 July 1952
Cert: 14264
Place of Death: County: Floyd City or Town:
Halo, Ky.
Length of stay (in this place): Life Time
Street Address or Location: Halo, Ky., Her Home
Usual Residence of Deceased: State: Ky. County:
Floyd
City or Town: Halo, Ky. Street
Address: Halo, Ky.
Full Name: Jane (Cook) JOHNSON
Date of Death: 02 July 1952
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 16 October 1896
Age: 55 years, 08 months, 16 days
Usual Occupation: House Wife
Kind of Industry or business: (blank)
Birthplace: Knott County
Father's Name: Lewis COOK
Mother's Maiden Name: Margaret HALL
Was deceased ever in armed forces: No
Social Security No.: None
Informant: (blank)
Disease or condition directly leading to death:
(illegible possibly says Coronary Thrombosis)
Interval between onset and death: (blank)
Due to: (blank)
Other significant conditions: Diabetes Mellitus
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: no
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 1948 to 02 July
1952, that I last saw the deceased alive on 25 June 1952(blank), and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: (illegible)
Address: ByPro, Ky.
Signature: W. J. Osborne, M.D.
Burial, Cremation or Removal: Burial
Date: 07 July 1952
Name of Cemetery or Crematory: Cook's Cemetery
Location: Halo, Ky.
Date received by local registrar: 10 July 1952
Registrar's Signature: Lucy Ransdell
Funeral director & address: Omar Paul (illegible)
Bypro, Ky.
Transcribed by Debbie Tamborski, 11 August 2010 |
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