Date: 16 September 1948
Cert: 19031
Place of Death: County: Knott City or
Town: Cordia
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Cordia
Full Name: Maudie MARTIN
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 16 June 1925
Age: 23 years, 03 months, 00 days
Birthplace: Knott
Occupation: (blank)
Industry or business: (blank)
Father Name: Allen MARTIN
Father Birthplace: Knott
Mother Maiden Name: Cassie SMITH
Mother Birthplace: Knott
Informant: Mrs. Allen MARTIN, Cordia, Ky.
Burial Place: Martin (Knott)
Date: 17 September 1948
Signature of funeral director: Engle's, Hazard, Ky.
Date received by local registrar: 29 September 1948
Registrar's Signature: Rose B. Craft
Date of Death: 16 September 1948
I hereby certify that I attended deceased from 12 July 1948 to
16 September 1948, that I last saw him alive on 16 September
1948, and that death
occurred on the date stated above at 11 p.m.
Immediate cause of death: Pulmonary T. B.
Duration: (illegible) years
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: A. B. Pigman, M.D., Allock
Date signed: 22 September 1948
Transcribed by Debbie Tamborski, 27 December 2010 |