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DEATH
CERTIFICATE
CARL KING
Date 21 October 1933
Cert: 24789
Place of Death: Voting Pct.: No. 1, M. Hospital,
Pikeville, Pike Co., Ky.
Full Name: Carl KING
Residence: Wheelwright
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Dora HALL
Date of Birth: (blank)
Age: 28 years
Occupation: Coal mining
Birthplace: Knott Co., Ky.
Father Name: Has KING
Birthplace Father: Knott Co., Ky.
Mother Maiden Name: (blank)
Birthplace Mother: (blank)
Informant/Address: Sill HALL, Wheelwright, Ky.
Burial Cremation Removal Place: Burial
Date: 21 October 1933
Undertaker/Address: J. W. Call & Son, Pikeville, Ky.
Filed: 23 October 1933
Registrar: J. C. Wright by W. P. Call, Dep.
Death of Date: 21 October 1933
I hereby certify, That I attended deceased from 17 October
1933 to
21 October 1933, that I last saw h-- alive on (blank), death is said
to have occurred on the date stated above, at (illegible)
Cause of Death: Slate fall - mine, crushing left femur &
rt. leg below knee
Date of onset: (blank)
Contributory causes: (blank)
Name of operation: (blank)
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: (blank)
Signed/Address: A. G. Osborn, M.D., Pikeville, Ky.
Transcribed by Debbie Tamborski, 02 April 2010 |
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