Date: 08 September 1944
Cert: 13013
Place of Death: County: Knott City or
Town: Amburgey (rural)
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Amburgey (rural)
Full Name: James Monroe KELLY
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Sarah BARGER
Age of husband or wife if alive: 58 years
Birth date of deceased: Unknown
Age: 60 years
Birthplace: Knott County, Kentucky
Occupation: Farmer
Industry or business: (blank)
Father Name: Unknown
Father Birthplace: Unknown
Mother Maiden Name: Unknown
Mother Birthplace: Unknown
Informant: George YARBER, Red Fox, Kentucky
Burial Place: Toliver Cemetery
Date: 09 September 1944
Signature of funeral director: None
Date received by local registrar: (blank)
Registrar's Signature: (blank)
Date of Death: 08 September 1944
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: High Blood Pressure Apoplexy
Duration: 05 years 03 weeks
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: J. W. Duke, M.D., Hindman,
Kentucky
Date signed: 19 March 1945
Transcribed by Debbie Tamborski, 14 November 2010 |