Date: 06 March 1945
Cert: 06261
Place of Death: County: Knott City or Town: Mallie,
Ky. Rural
Street Number or Location: Home
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Mallie Rural
Full Name: (Rebecca) Becky JONES
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Widow
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 02 June 1859
Age: 85 years, 09 months, 04 days
Birthplace: not known
Occupation: House wife
Industry or business: (blank)
Father Name: unknown
Father Birthplace: (blank)
Mother Maiden Name: unknown
Mother Birthplace: (blank)
Informant: Hattie Slone, Mattie, Ky.
Burial Place: Home Cemetery
Date: 08 March 1945
Signature of funeral director: (blank)
Date received by local registrar: 29 March 1945
Registrar's Signature: Rose B. Craft
Date of Death: 06 March 1945
I hereby certify that I attended deceased from 03 March 1945 to
03 March 1945, that I last saw him alive on (blank), and that
death occurred on the date stated above at 9 p.m.
Immediate cause of death: Pneumonia caused by influenza
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: M. F. Kelley, M.D., Hindman,
Ky.
Date signed: 29 March 1945
Transcribed by Debbie Tamborski, 29 November 2010 |