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DEATH
CERTIFICATE
SARAH JOHNSON
Date 28 April 1943
Cert: 10759
Place of Death: County: Floyd Co., Ky. City or Town:
Lambert
Street No. or Location: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Floyd
City or Town: Lambert
Full Name: Sarah JOHNSON
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: E. L. JOHNSON
Age of husband or wife if alive: 59 years
Birth date of deceased: 26 August 1887
Age: 56 years, 08 months, 01 days
Birthplace: Knott Co., Ky.
Occupation: Domestic
Industry or business: (blank)
Father Name: Henry THORNSBERRY
Father Birthplace: Floyd Co., Ky.
Mother Maiden Name: Liza MULLINS
Mother Birthplace: Knott Co., Ky.
Informant: E. L. JOHNSON, Fed, Ky.
Burial Place: Buckingham, Ky.
Date: 30 April 1943
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: 07 May 1943
Registrar's Signature: Winifred Norris
Date of Death: 28 April 1943
I hereby certify that I attended deceased from 04 January 1943 to
22 April 1943, that I last saw him alive on 22 April 1943, and
that death occurred on the date stated above at 11:50 p.m.
Immediate cause of death: Tuberculosis of lung
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: W. D. Osborne, Bypro
Date signed: 03 May 1943
Transcribed by Debbie Tamborski, 31 May 2010 |
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