Date: 12 December 1948
Cert: 27407
Place of Death: County: Knott City or
Town: Ivis, Ky. Rural
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Ivis, Ky. Rural
Full Name: Nebraska JONES
Date of Death: 12 December 1948
Sex, Color or Race, Marital Status: Female, White,
Widowed
Date of Birth: 11 January 1889
Age: 59 years
Usual Occupation: Housewife
Kind of Industry or business: Country Store
Birthplace: Knott Co., Ky.
Father's Name: Harrison HALL
Mother's Maiden Name: Elizabeth BATES
Was deceased ever in armed forces: No
Social Security No.: (blank)
Informant: Olive May JONES
Disease or condition directly leading to death: Uremia
with myocardial failure
Interval between onset and death: 15 hours
Due to: Myocardial insufficiency cardiac enlargement
Due to: Valvular insufficiency & cardiac decompensation
Interval between onset and death: 03 years
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 15 September
1948 to 12 December 1948, that I last saw the deceased alive
on 12 December 1948, and that death occurred at 7:30 p.m.,
from the causes and on the date stated above.
Date signed: 13 January 1949
Address: Hindman, Ky.
Signature: D. G. Barker, M.D.
Burial, Cremation or Removal: Burial
Date: 14 December 1948
Name of Cemetery or Crematory: Jones Cemetery
Location: Ivis, Knott Co., Ky.
Date received by local registrar: 15 January 1949
Registrar's Signature: Rose B. Craft
Funeral director & address: Engle's, Hazard, Ky.
Transcribed by Debbie Tamborski, 27 December 2010 |