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DEATH
CERTIFICATE
LAWRENCE JONES
Date: 01 September 1950
Cert: 21457
Place of Death: County: Perry City or Town:
Hazard
Length of stay (in this place): (blank)
Name of Hospital or Institution: Hurst-Snyder Hospital
Usual Residence of Deceased: State: Ky. County:
Perry
City or Town: Sassafras Street Address: (blank)
Full Name: Lawrence JONES
Date of Death: 01 September 1950
Sex, Color or Race, Marital Status: Male, White, Single
Date of Birth: 05 August 1945
Age: 05 years
Usual Occupation: none
Kind of Industry or business: none
Birthplace: Sassafras, Ky.
Father's Name: Ezra JONES
Mother's Maiden Name: Berniece MADDING
Was deceased ever in armed forces: non
Social Security No.: none
Informant: Berniece MADDING
Disease or condition directly leading to death: Second &
third degree burns on 70% of body surface
Interval between onset and death:
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
Accident, suicide, or homicide: (blank)
Place of injury: home
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (illegible) ???ing in front of
(illegible) grate
I hereby certify that I attended deceased from 01 September
1950 to
01 September 1950, that I last saw the deceased alive on (blank), and
that death occurred at 10 p.m., from the causes and on the
date stated above.
Date signed: 06 September 1950
Address: Hazard, Ky.
Signature: Paul W. Gutsche, M.D.
Burial, Cremation or Removal: Burial
Date: 03 September 1950
Name of Cemetery or Crematory: Cornett Hill
Location: Sassafras, Ky.
Date received by local registrar: 11 September 1950
Registrar's Signature: Georgia Pendleton
Funeral director & address: Maggard and Garrett,
Hazard, Ky.
Transcribed by Debbie Tamborski, 15 July 2010 |
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