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DEATH
CERTIFICATE
BERNISE MARTIN
Date 28 October 1937
Cert: 28891
Name: Bernise MARTIN
Place of Death: Voting Pct. #19 Lackey, St. M.
Hosp., Knott Co., KY
Residence: Wayland, Ky.
Length of residence: (blank)
Male, White, Married
Husband or Wife of: (blank)
Birth Date: (blank)
Age: 25 years
Occupation: Miner
Place of Birth: Knott Co.
Name of Father: Robert MARTIN
Birthplace Father: Knott Co.
Maiden Name of Mother: Julia WICKER
Birthplace Mother: Knott Co.
Informant: Robert MARTIN, Wayland
Death Date: 28 October 1937
Cause of Death: Accident caused by train reck.
Fractured skull. Broken L. Leg. Internal injuries
Signed: W. L. Stumbo, M.D., Lackey, Ky.
Burial Place: Garrett, Ky.
Date of Burial: 29 October 1937
Undertaker: 23 November 1937
File Date: Dr. G. C. Collins, D.D.S., Lackey, Ky.
Registrar:
Transcribed by Debbie Tamborski, 30 September 2009 |
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