Date: 26 June 1951
Cert: 16606
Place of Death: County: Knott
City or Town: Lackey
Length of stay (in this place): 02 days
Name of Hospital or Institution: Stumbo Memorial
Hospital
Usual Residence of Deceased: State: Ky.
County: Floyd
City or Town: Halo, Ky. Street
Address: None
Full Name: Suzie JUSTICE
Date of Death: 26 June 1951
Sex, Color or Race, Marital Status: Female, White, Widowed
Date of Birth: 03 March 1883
Age: 68 years, 01 months, 22 days
Usual Occupation: Housewife
Kind of Industry or business: Home
Birthplace: Ky.
Father's Name: J. J. BELCHER
Mother's Maiden Name: Elliza CAMPBELL
Was deceased ever in armed forces: non
Social Security No.: none
Informant: Mr. Jim BELCHER
Disease/condition directly leading to death: Pulmonary
Infarction
Interval between onset and death: 07 days
Due to: Cardiac Decompensation
Interval between onset and death: 07 days
Due to: Hypertensive Cardiovascular Renal Disease
Interval between onset and death: 03 years
Other significant conditions: Diabetes Mellitus
Interval between onset and death: unknown
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
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 24 June 1951 to
26 June 1951, that I last saw the deceased alive on 26 June
1951, and that death occurred at 7:45 p.m., from the causes
and on the date stated above.
Date signed: 26 June 1951
Address: Lackey, Ky.
Signature: Martha A. Loving, M.D.
Burial, Cremation or Removal: Burial
Date: 28 June 1951
Name of Cemetery or Crematory: (blank)
Location: Olive Hill, Ky.
Date received by local registrar: 08 August 1951
Registrar's Signature: Rose B. Craft
Funeral director & address: Omar Paul Greene, ByPro, Ky.
Transcribed by Debbie Tamborski, 21 January 2011 |