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DEATH
CERTIFICATE
SAMUEL M. KELLEY
Date 25 January 1927
Cert: # 1694
Name: Samuel M. KELLEY
Place of Death: Voting Pct. #15, Knott Co., KY
Male, White, Married
Birth Date: 20 March 1899
Age: 27 years, 10 months, 07 days
Occupation: Coal Miner, Knott Coal Corp.
Place of Birth: Knott County, Ky.
Name of Father: Thomas KELLEY
Birthplace Father: Knott Co., Ky.
Maiden Name of Mother: Nancy FRANCIS
Birthplace Mother: Knott Co., Ky.
Informant: Will KELLEY by W. B. HOPKINS, Anco, Ky.
Death Date: 25 January 1927
Cause of Death: Comminuted fracture of back and internal
injuries due to coal falling on him in mines.
Instantaneous
Signed: W. B. Hopkins, M.D.
Burial Place: Sassafras, Ky.
Date of Burial: 27 January 1927
Undertaker: Non
File Date: 03 February 1927
Transcribed by Debbie Tamborski, 14 January 2009 |
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