Date: 19 July 1941
Cert: 17944
Place of Death: County: Knott City or
Town: Lackey, Ky.
Name of Hospital or Institution: Stumbo Memorial
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Garrett, Ky.
Full Name: Tyrone MASSEY
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: 28 January 1941
Age: 05 months, 21 days
Birthplace: Lackey, Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Rudolph MASSEY
Father Birthplace: (blank)
Mother Maiden Name: Sinda GAYHEART
Mother Birthplace: Knott Co.
Informant: Sinda GAYHEART, Garrett, Ky.
Burial Place: Garrett, Ky.
Date: 20 July 1941
Signature of funeral director: O. T. Lemaster, Martin, Ky.
Date received by local registrar: 31 July 1941
Registrar's Signature: Macie Miller
Date of Death: 19 July 1941
I hereby certify that I attended deceased from 18 July 1941 to
19 July 1941, that I last saw him alive on 04 July 1941, and
that death occurred on the date stated above at 3:30 p.m.
Immediate cause of death: Bronchial pneumonia
Duration: 03 days
Due to: (blank)
Other conditions: non specific diarrhea
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: C. R. Messer, M.D., Lackey, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 14 October 2010 |