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DEATH
CERTIFICATE
ANNA MARTIN
Date 02 April 1947
Cert: 08132
Place of Death: County: Fayette City or
Town: Lexington
Name of Hospital or Institution: Good Sam. North
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Vest
Full Name: Anna MARTIN
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Widowed
Husband or Wife of: John D. MARTIN
Age of husband or wife if alive: (blank)
Birth date of deceased: 06 November 1865
Age: 81 years, 05 months, 04 days
Birthplace: Drift, Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: John B. TURNER
Father Birthplace: Floyd Co., Ky.
Mother Maiden Name: Mary MARTIN
Mother Birthplace: Floyd Co., Ky.
Informant: (illegible--?Rebe?) MARTIN
Burial Place: Drift, Ky.
Date: 04 April 1947
Signature of funeral director: G. D. Ryan, Martin, Ky.
Date received by local registrar: 07 April 1947
Registrar's Signature: D. A. Furlong
Date of Death: 02 April 1947
I hereby certify that I attended deceased from 24 March 1947 to
03 April 1947, that I
last saw him alive on 03 April 1947, and that death occurred on the date
stated above at 9:32 a.m.
Immediate cause of death: Circulatory failure
Due to: Arteriosclerrtia heart disease, chronic
nephritis, uremia
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: Chas. N. Kavanaugh, M.D., Lexington, Ky.
Date signed: 08 April 1947
Transcribed by Debbie Tamborski, 12 February 2010 |
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