Date: 16 September 1953
Cert: 19127
Place of Death: County: Knott
City or Town: Lackey
Length of stay (in this place): (blank)
Street address or location: Stumbo Memorial
Usual Residence of Deceased: State: Ky.
County: Floyd
City or Town: (illegible ?Garrett?) If rural give
location:
(blank)
Full Name: Ollie James MARTIN Jr.
Date of Death: 16 September 1953
Sex, Color or Race, Marital Status: Male, White, Infant
Date of Birth: 16 September 1953
Age: 01 days
Usual Occupation: None
Kind of Industry or business: Infant
Birthplace: Stumbo Memorial
Father's Name: Ollie James MARTIN
Mother's Maiden Name: Ruth WIREMAN
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Ollie James MARTIN
Disease or condition directly leading to death: Atelectasis
Interval between onset and death: (blank)
Due to: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
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 16 September
1953 to
16 September 1953, that I last saw the deceased alive on 16
September 1953, and
that death occurred at 6:00 p.m., from the causes and on the
date stated above.
Date signed: 17 September 1953
Address: Lackey, Ky.
Signature: C. M. Aker, M.D.
Burial, Cremation or Removal: Burial
Date: 17 September 1953
Name of Cemetery or Crematory: Family Cem.
Location: Martin, Ky.
Date received by local registrar: 23 September 1953
Registrar's Signature: Mrs. Rose B. Craft
Funeral director & address: Hall Bros., Martin, Ky.
Transcribed by Debbie Tamborski, 09 February 2011 |