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DEATH
CERTIFICATE
HELLENE AGNIS MATHIAS
Date 05 April 1937
Cert: 19112
Name: Hellene Agnis MATHIAS
Place of Death: Vot. Pct. #19 Lackey, Stumbo M.
Hosp., Knott Co., KY
Residence: Garrett, Ky.
Length of residence: ?? yrs.
Female, White, Married
Husband or Wife of: Wife
Birth Date: 28 July 1886
Age: 50 years, 08 months, 08 days
Occupation: Domestic
Place of Birth: Pennsylvania
Name of Father: John (?Kanfor?)
Birthplace Father: Indiana
Maiden Name of Mother: Harriet WALKER
Birthplace Mother: Indiana
Informant: Albert MATHIAS, Garrett, Ky.
Death Date: 05 April 1937
Cause of Death: Cancer of the stomach
Signed: Dr. W. L. Stumbo, M.D., Lackey, Ky.
Burial Place: Garrett, Ky.
Date of Burial: 08 April 1937
Undertaker: G. D. Ryan, Martin, Ky.
File Date: 16 July 1937
Registrar: Dr. G. C. Collins, D.D.S., Lackey, Ky.
Transcribed by Debbie Tamborski, 03 October 2009 |
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