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DEATH
CERTIFICATE
TOM KING
Date: 01 February 1946
Cert: 06062
Place of Death: County: Floyd City or Town:
Hospital or Institution: Beaver Valley Hosp., Martin
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Floyd
City or Town: Bevinsville, Ky.
Full Name: Tom KING
If Veteran Name War: (blank)
Social Security No.: 400-339-6542
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Stamley KING
Age of husband or wife if alive: 28 years
Birth date of deceased: 21 January 1907
Age: 39 years
Birthplace: Knott Co., Ky.
Occupation: Mining & farming
Industry or business: (blank)
Father Name: Lindsey KING
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Nannie COLLINS
Mother Birthplace: Letcher Co., Ky.
Informant: Allen TRIPLETT
Burial Place: Hall Cemetery
Date: 03 February 1946
Signature of funeral director: Ryan Funeral Home, Martin, Ky.
Date received by local registrar: 11 March 1946
Registrar's Signature: Lucy Ramsdell
Date of Death: 01 February 1946
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:
Duration: (blank)
Due to: Slate fall in mines
Major findings of operations: (blank)
Accident, suicide, or homicide: accident
Date of occurrence: 01 February 1946
Where did injury occur: coal mines
While at work: yes
Means of injury: crushed
Signature & Address: C. L. Allen, M.D., Martin, Ky.
Date signed: 07 March 1946
Transcribed by Debbie Tamborski, 09 June 2010 |
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