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DEATH
CERTIFICATE
ROBERT JOHNSON
Date 10 July 1929
Cert: 20164
Place of Death: Voting Pct: #16, Pikeville, Pike Co., Ky.
Full Name: Robert JOHNSON
Residence: Pikeville, Ky.
Length of Residence in city where death occurred:
(blank)
Sex, Color or Race, Marital Status: Male, Colored,
Married
Husband or Wife of: Eliza JOHNSON
Date of Birth: 09 May 1843
Age: 86 years, 01 months, 21 days
Occupation: Farmer
Birthplace: Knott County, Ky.
Father Name: Wash JOHNSON
Birthplace Father: Ky.
Mother Maiden Name: Racheal JOHNSON
Birthplace Mother: Ky.
Informant/Address: Frank JOHNSON, Pikeville, Ky.
Filed: 10 July 1929
Registrar: J. C. Wright
Death of Date: 10 July 1929
I hereby certify that I attended deceased from 01 July 1929 to
July 1929, that I last saw h-- alive on (blank), and that
death occurred on the date stated above at 11 p.m.
Cause of Death: Chronic interstitial nephritis
Duration: (blank)
Contributory: (blank)
Duration: (blank)
Where was disease contracted if not at place of death?:
(blank)
Did an operation precede death: (blank) Date: (blank)
Was there an autopsy: (blank)
What test confirmed diagnosis: (blank)
Signed/Address: R. Johnson, M.D., 15 July 1929,
Pikeville, Ky.
Place of Burial or Removal: Cline Cemetery
Date of Burial: 12 July 1929
Undertaker/Address: J. W. Call & Son, Pikeville, Ky.
Transcribed by Debbie Tamborski, 27 March 2010 |
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