|
DEATH
CERTIFICATE
NANCY ANN JONES
Date: 14 February 1953
Cert: 06602
Place of Death: County: Perry City or Town:
Duane
Length of stay (in this place): (blank)
Street address or location: Home
Usual Residence of Deceased: State: Kentucky County:
Perry
City or Town: Duane Street
Address: Duane
Full Name: Nancy Ann JONES
Date of Death: 14 February 1953
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 04 May 1886
Age: 67 years
Usual Occupation: Housewife
Kind of Industry or business: Home
Birthplace: Knott Co., Kentucky
Father's Name: Mack NAPIER
Mother's Maiden Name: Jane ALLEN
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Levi JONES
Disease or condition directly leading to death:
Hypertensive C. V. Disease
Interval between onset and death: (blank)
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: (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 June 1953
(transcribed as written) to 14 February 1953, that I last saw the deceased alive on
13 February 1953, and
that death occurred at 2:00 p.m., from the causes and on the
date stated above.
Date signed: 19 February 1953
Address: Hazard, Ky.
Signature: (illegible)
Burial, Cremation or Removal: Burial
Date: 17 February 1953
Name of Cemetery or Crematory: Holliday Cemetery
Location: Ary, Kentucky
Date received by local registrar: 09 March 1953
Registrar's Signature: Georgia P. Surer
Funeral director & address: Engle Funeral Home,
Hazard, Kentucky
Transcribed by Debbie Tamborski, 13 August 2010 |
|