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DEATH
CERTIFICATE
ROSCOE C. KILGORE
Date 28 January 1949
Cert: 3080
Place of Death: County: Perry City or Town:
Hazard
Length of stay in hospital or community: (blank)
Name of Hospital or Institution: Mt. Mary
Usual Residence of Deceased: State: Ky. County: Knott
City or Town: Hindman
Full Name: Roscoe C. KILGORE
Date of Death: 28 January 1949
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 29 October 1883
Age: 66 years
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Hazard, Ky.
Father's Name: Sam KILGORE
Mother's Maiden Name: Dora POLLY
Was deceased in ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Joe KILGORE
Disease or condition directly leading to death: Clermie
myocarditis with heart failure
Interval between onset and death: Coronary Occlusion
Due to: 27 January 1949 to 28 January 1949
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings for operation: (blank)
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 27 January 1949 to
(blank), that I
last saw the deceased alive on 27 January 1949, and that death occurred on
the date stated above at 4:20 a.m, from the causes and on the date
stated above.
Date signed: 05 February 1949
Address: Hazard, Ky.
Signature: Martin Palmer, M.D.
Burial, Cremation or Removal: Buried
Date: 30 January 1949
Name of Cemetery or Creamatory: Kilgore
Location: Hindman, Ky.
Date received by local registrar: 08 March 1949
Registrar's Signature: Helen Burriss
Funeral director and address: Engle's, Hazard, Ky.
Transcribed by Debbie Tamborski, 15 February 2010 |
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