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DEATH
CERTIFICATE
SAILOR JOHNSON
Date 06 January 1946
Cert: Original # 08528
Place of Death: County: Floyd City or
Town: Martin
Name of Hospital or Institution: Beaver Valley Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: (blank)
Full Name: Sailor JOHNSON
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 21 June 1945
Age: 06 months
Birthplace: Knott Co., Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Junior JOHNSON
Father Birthplace: Weeksbury, Ky.
Mother Maiden Name: Oma THORNESBURY
Mother Birthplace: Dry Creek, Ky.
Informant: Junior JOHNSON, Hall, Ky.
Burial Place: Hall, Ky.
Date: 07 January 1946
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: 30 April 1946
Registrar's Signature: Lucy Ramsdell
Date of Death: 06 January 1946
I hereby certify that I attended deceased from 06 January 1946 to
06 January 1946, that I
last saw him alive on 06 January 1946, and that death occurred on the date
stated above at 10:00 p.m.
Immediate cause of death: Bronchial pneumonia bilateral
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: Robert M. Seible, M.D.
Date signed: (blank)
Transcribed by Debbie Tamborski, 10 February 2010 |
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