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DEATH
CERTIFICATE
Mrs. JOHN LOVELY
Date 02 April 1936
Cert: 13997
Place of Death: Voting Pct.: Paintsville Hospital,
Paintsville, Johnson Co., Ky.
Full Name: Mrs. John LOVELY
Residence: Wayland
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: John LOVELY
Date of Birth: 03 March 1911
Age: (blank)
Occupation: House wife
Birthplace: Knott Co.
Father Name: Daniel PELPHREY
Birthplace Father: Kentucky
Mother Maiden Name: Rebecca SPURTAN
Birthplace Mother: Kentucky
Informant/Address: John LOVELY, Wayland
Burial Cremation Removal Place: (blank)
Date: (blank)
Undertaker/Address: (blank)
Filed: 05 April 1937
Registrar: Mrs. M. J. Wells
Death of Date: 02 April 1936
I hereby certify, That I attended deceased from 26 March 1936 to
02 April 1836, that I last saw her alive on 02 April 1936, death is said
to have occurred on the date stated above, at 7 p.m.
Cause of Death: Septicemia following
miscarriage 4 months (illegible)
Date of onset: (blank)
Contributory causes: none
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: (illegible) Jr., M.D., Paintsville, Ky.
Transcribed by Debbie Tamborski, 21 April 2010 |
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