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DEATH
CERTIFICATE
JAMES MARTIN
Date 16 January 1946
Cert: 02452
Place of Death: County: Perry City or
Town: Hazard
Name of Hospital or Institution: Hazard Hosp.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural Street No.:
Litt Car, Ky.
Full Name: James MARTIN
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 22 September
Age: 05 years
Birthplace: Knott Co., Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Mack MARTIN
Father Birthplace: Ky.
Mother Maiden Name: Ida SHORT
Mother Birthplace: Ky.
Informant: Mack MARTIN, Litt Car, Ky.
Burial Place: Litt Car, Ky.
Date: 17 January 1946
Signature of funeral director: Joe Greer, Hazar, Ky.
Date received by local registrar: 21 January 1946
Registrar's Signature: Opsie J. Deaton
Date of Death: 16 January 1946
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: Meningitis
Due to: Cause undetermined
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: J. E. Hagan, M.D., Hazard, Ky.
Date signed: 22 January 1946
Transcribed by Debbie Tamborski, 10 February 2010 |
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