Date: 12 July 1949
Cert: 14550
Place of Death: County: Knott
City or Town: Amburgy
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Amburgy Street Address:
(blank)
Full Name: Tesh JOHNSON
Date of Death: 12 July 1949
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 1882
Age: 67 years
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Knott Co., Ky.
Father's Name: Jack COMBS
Mother's Maiden Name: Elizebeth COMBS
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: (blank)
Disease or condition directly leading to death: Myocardial
Insufficiency
Interval between onset and death: 02 1/2 weeks
Due to: Arteriosclerotic Heart Disease
Interval between onset and death: undet.
Other significant conditions: Pleural Effusion Left Lung
Interval between onset and death: 07 months
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 15 March 1948
to 25 June 1949, that I last saw the deceased alive on 25 June
1949, and that death occurred at 5 p.m., from the causes and
on the date stated above.
Date signed: 21 July 1949
Address: Hindman, Ky.
Signature: D. G. Barker, M.D.
Burial, Cremation or Removal: Burial
Date: 14 July 1949
Name of Cemetery or Crematory: Flax Patch
Location: Knott, Ky.
Date received by local registrar: 22 July 1949
Registrar's Signature: Rose B. Craft
Funeral director & address: Engles, Hazard, Ky.
Transcribed by Debbie Tamborski, 05 January 2011 |