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DEATH
CERTIFICATE
ZELPHIA KERKSEY
Date: 28 June 1952
Cert: 14125
Place of Death: County: Fayette City or Town:
Lexington, Kentucky
Length of stay (in this place): 01 year, 01 month, 16
days
Name of Hospital or Institution: Eastern State Hospital
Usual Residence of Deceased: State: Kentucky County:
Perry
City or Town: Lothair Street Address: (blank)
Full Name: Zelphia KERKSEY
Date of Death: 28 June 1952
Sex, Color or Race, Marital Status: Female, Black, Married
Date of Birth: 20 July 1913
Age: 38 years
Usual Occupation: Housewife
Kind of Industry or business: (blank)
Birthplace: Knott County, Kentucky
Father's Name: London FRANCIS
Mother's Maiden Name: Susie WILLIAMS
Was deceased ever in armed forces: No
Social Security No.: (blank)
Informant: Hospital Records
Disease or condition directly leading to death: Ruptured
Tubo-Ovarian Abcess
Interval between onset and death: Unknown
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: yes
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 05 January 1951 to
28 June 1952, that I last saw the deceased alive on 28 June
1952, and
that death occurred at 6:45 a.m. (CDST), from the causes and on the
date stated above.
Date signed: 28 June 1952
Address: Eastern State Hospital
Signature: A. C. Beckett, M.D.
Burial, Cremation or Removal: Burial
Date: 30 June 1952
Name of Cemetery or Crematory: Higgins Cem.
Location: Perry Co., Ky.
Date received by local registrar: 11 July 1952
Registrar's Signature: D. A. Furlong
Funeral director & address: Charles Haggard, Lex.,
Ky.
Transcribed by Debbie Tamborski, 11 August 2010 |
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