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DEATH
CERTIFICATE
PEARL MARTIN
Date 16 February 1942
Cert: 03101
Place of Death: County: Fayette City or Town:
Lexington
Hospital or Institution: Eastern State Hospital
Length of stay in hospital or community: 13 days
Usual Residence of Deceased: State: Kentucky County:
Perry
City or Town: Bulan
Full Name: Pearl MARTIN
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Divorced
Husband or Wife of: Lonnie SUFFRAGE
Age of husband or wife if alive: (blank)
Birth date of deceased: 27 September 1905
Age: 36 years, 04 months, 29 days
Birthplace: Knott County, Ky.
Occupation: Housework
Industry or business: (blank)
Father Name: Ben MARTIN
Father Birthplace: Bulan, Kentucky
Mother Maiden Name: Delila SMITH
Mother Birthplace: Bulan, Kentucky
Informant: Eastern State Hospital Records, Lexington, Kentucky
Burial Place: Bulan, Ky.
Date: 18 February 1942
Signature of funeral director: Maggard & Garrett, Hazard, Ky.
Date received by local registrar: 23 February 1942
Registrar's Signature: D. A. Furlong
Date of Death: 16 February 1942
I hereby certify that I attended deceased from 03 February
1942 to
16 February 1942, that I last saw her alive on 16 February
1942, and that death
occurred on the date stated above at 10:20 a.m.
Immediate cause of death: Syphilis of central nervous system
meningo overphabtic type
Duration: 01 week
Due to: Syphilis
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: G. G. Auxier, M.D., E. State
Hosp., Lexington, Ky.
Date signed: 16 February 1942
Transcribed by Debbie Tamborski, 26 May 2010 |
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