Date: 11 April 1953
Cert: 17003
Place of Death: County: Knott
City or Town: Lackey
Length of stay (in this place): (blank)
Street address or location: Stumbo Memorial
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Ivis (Rural) If rural give
location:
(blank)
Full Name: Clarence Edward LAWSON
Date of Death: 11 April 1953
Sex, Color or Race, Marital Status: Male, White, No
Date of Birth: 12 March 1950
Age: 03 years
Usual Occupation: No
Kind of Industry or business: No
Birthplace: Ivis, Ky.
Father's Name: Melvin LAWSON
Mother's Maiden Name: Dora
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Dora LAWSON
Disease or condition directly leading to death: Severe burns
Interval between onset and death: (blank)
Due to:
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
Accident, suicide, or homicide: accident
Place of injury: Rural home
City or Town, County, State: Ivis, Kentucky, Knott County
Time of Injury: 10 April 1953, 12 a.m.
Injury occurred at work: Not while at work
How did injury occur: Fell in tub of water
I hereby certify that I attended deceased from 10 April 1953 to
11 April 1953, that I last saw the deceased alive on 11 April
1953, and
that death occurred at 7:30 p.m., from the causes and on the
date stated above.
Date signed: 15 April 1953
Address: Lackey, Ky.
Signature: Curtis G. Wherry, M.D.
Burial, Cremation or Removal: Burial
Date: 13 April 1953
Name of Cemetery or Crematory: Ivis Cemetery
Location: Ivis, Ky.
Date received by local registrar: 16 July 1953
Registrar's Signature: Mrs. Rose B. Craft
Funeral director & address: John Everage, Hindman,
Ky.
Transcribed by Debbie Tamborski, 09 February 2011 |