|
DEATH
CERTIFICATE
ANNA MARIA KELLY
Date 20 November 1945
Cert: 24379
Place of Death: County: Perry City or
Town: Hazard
Name of Hospital or Institution: Hazard Hosp.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Amburgey
Full Name: Anna Maria KELLY
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 10 November 1945
Age: 11 days
Birthplace: Knott Co., Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Benett KELLY
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Eliza HALL
Mother Birthplace: Floyd Co., Ky.
Informant: Benett KELLY, Amburgey, Ky.
Burial Place: Amburgey
Date: 22 November 1945
Signature of funeral director: Maggard, Hazard, Ky.
Date received by local registrar: 21 November 1945
Registrar's Signature: Opsie J. Deaton
Date of Death: 20 November 1945
I hereby certify that I attended deceased from 15 November
1945 to
20 November 1945, that I
last saw him alive on 20 November 1945, and that death occurred on the date
stated above at 7:30 p.m.
Immediate cause of death: Pneumonia
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: E. (illegible), M.D., Hazard, Ky.
Date signed: 21 November 1945
Transcribed by Debbie Tamborski, 09 February 2010 |
|