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DEATH
CERTIFICATE
NANCY MADDOX
Date: 01 December 1950
Cert: 26133
Place of Death: County: Morgan City or Town:
Insco
Length of stay (in this place): 35 years
Street Address or location: Insco
Usual Residence of Deceased: State: Ky. County:
Morgan
City or Town: (blank) Street
Address: Morgan Co.
Full Name: Nancy MADDOX
Date of Death: 01 December 1950
Sex, Color or Race, Marital Status: Female, White,
Married
Date of Birth: 25 September 1868
Age: 82 years, 02 months, 06 days
Usual Occupation: Housewife
Kind of Industry or business: Housework
Birthplace: Knott Co., Ky.
Father's Name: (?)ick SMITH
Mother's Maiden Name: (blank)
Was deceased ever in armed forces: no
Social Security No.: no
Informant: Harrison MADDOX
Disease or condition directly leading to death: Coronary
Heart Disease
Interval between onset and death: (blank)
Due to: Coronary Thrombosis
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw the deceased alive on (blank), and
that death occurred at 5:30 p.m., from the causes and on the
date stated above.
Date signed: 04 December 1950
Address: West Liberty, Ky.
Signature: W. H. Wells, Coroner
Burial, Cremation or Removal: (illegible)
Date: 06 December 1950
Name of Cemetery or Crematory: Family
Location: Insco, Ky.
Date received by local registrar: 06 December 1950
Registrar's Signature: Helen Black
Funeral director & address: M. D. Potter, West
Liberty, Ky.
Transcribed by Debbie Tamborski, 15 July 2010 |
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