Date: 10 March 1947
Cert: 09216
Place of Death: County: Knott City or
Town: Mousie, Ky. Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Mousie Rural
Full Name: Russell JOHNSON
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White,
Married
Husband or Wife of: Ranie STEWART
Age of husband or wife if alive: 56 years
Birth date of deceased: 25 December 1880
Age: 66 years, 02 months, 15 days
Birthplace: Lackey, Ky.
Occupation: Merchant & Teacher
Industry or business: (blank)
Father Name: Martin JOHNSON
Father Birthplace: Virginia
Mother Maiden Name: Sherilda
Mother Birthplace: Kentucky
Informant: Geneva J. SMITH, Hindman, Ky.
Burial Place: Mousie, Ky.
Date: 13 March 1947
Signature of funeral director: E. P. Arnold,
Prestonsburg
Date received by local registrar: 31 March 1947
Registrar's Signature: Rose B. Craft
Date of Death: 10 March 1947
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Heart attack while working in
the garden
Duration: (blank)
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: J. W. Duke, M.D., Hindman, Ky.
Date signed: 30 April 1947
Transcribed by Debbie Tamborski, 18 December 2010 |