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DEATH
CERTIFICATE
AMERICA KEENE
Date 21 January 1938
Cert: 02581
Place of Death: Voting Pct.: Hellier, Pike Co., Ky.
Full Name: America KEENE
Residence: Hellier, Ky.
Length of Residence: 20 years
Sex, Color or Race, Marital Status: Female, White,
Widowed
Husband or Wife of: Jim KEENE
Date of Birth: 1867
Age: 71 years
Occupation: Housekeeper
Birthplace: Knott Co., Ky.
Father Name: William PRATER
Birthplace Father: Knott Co., Ky.
Mother Maiden Name: Margaret PRATER
Birthplace Mother: Knott Co., Ky.
Informant/Address: Keene family, Hellier, Ky.
Burial Cremation Removal Place: Hellier, Ky.
Date: 23 January 1938
Undertaker/Address: George England Acting, Hellier, Ky.
Filed: 05 February 1938
Registrar: Harriet Ratliff
Death of Date: 21 January 1938
I hereby certify, That I attended deceased from 20 January
1938 to
(blank), that I last saw h-- alive on (blank), death is said
to have occurred on the date stated above, at (blank)
Cause of Death: Lobar neumonia [sic]
Date of onset: (blank)
Contributory causes: (blank)
Name of operation: (blank)
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Ky.
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: (blank)
Signed/Address: Charlie Shields, M.D., Lookout, Ky.
Transcribed by Debbie Tamborski, 30 April 2010 |
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