DEATH
CERTIFICATE
MISIL JONES
Date: 10 March 1948
Cert: 15378
Place of Death: County: Perry
City or Town: Ary
Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Perry
City or Town: Ary
Full Name: Misil JONES
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 1908
Age: 40 years
Birthplace: Knott
Occupation: (blank)
Industry or business: (blank)
Father Name: Unknown
Father Birthplace: "
Mother Maiden Name: "
Mother Birthplace: "
Informant: Mrs. Charles JONES, Ary, Ky.
Burial Place: Ary (Perry)
Date: 14 March 1948
Signature of funeral director: Engles, Hazard, Ky.
Date received by local registrar: 05 June
1948
Registrar's Signature: Helen Burriss
Date of Death: 10 March 1948
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 8:30 p.m.
Immediate cause of death: (illegible)
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: Ed H. Ivey, Coroner, Hazard, Ky.
Date signed: (illegible)
Transcribed by Debbie Tamborski, 01 July 2010 |
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