Date: 09 January 1944
Cert: 09957
Place of Death: County: Knott City or
Town: Amburgey, Ky.
Street Number or Location: Rural
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Amburgey, Ky.
Street No.: Rural
Full Name: Belle MADDIN
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Widowed
Husband or Wife of: John MADDIN
Age of husband or wife if alive: (blank)
Birth date of deceased: 09 November 1860
Age: 83 years, 02 months
Birthplace: Spider, Ky.
Occupation: Housewife
Industry or business: Housekeeping
Father Name: James STAMPER
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Elsie Beth FRANCIS
Mother Birthplace: Knott Co., Ky.
Informant: Berta CODY, Amburgey, Ky.
Burial Place: (blank)
Date: (blank)
Signature of funeral director: Family, Amburgey, Ky.
Date received by local registrar: (blank)
Registrar's Signature: (blank)
Date of Death: 09 January 1944
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: Hypostatic pneumonia following
throat infection
Duration: (blank)
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: J. R. Aker, M.D., Anco, Ky.
Date signed: 19 April 1944
Transcribed by Debbie Tamborski, 15 November 2010 |