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DEATH
CERTIFICATE
WILEY MAXIE
Date 01 March 1938
Cert: 07311
Place of Death: Voting Pct.: Democrat, Letcher Co., Ky.
Full Name: Wiley MAXIE
Residence: Deane, Ky.
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Mrs. Wiley MAXIE
Date of Birth: About 1898
Age: about 40 years, ? months, ? days
Occupation: Farmer
Birthplace: Knott Co., Ky.
Father Name: ?
Birthplace Father: ?
Mother Maiden Name: ?
Birthplace Mother: ?
Informant/Address: Mrs. Howard BENTLEY
(neighbor), Deane, Ky.
Burial Cremation Removal Place: Knott Co., Ky.
Date: 03 March 1938
Undertaker/Address: Family & Friends, Deane, Ky.
Filed: 18 March 1938
Registrar: J. Don Collins
Death of Date: 01 March 1938
I hereby certify, That I attended deceased from (blank) to
(blank), that I last saw h-- alive on (blank), death is said
to have occurred on the date stated above, at noon
Cause of Death: Killed instantly by a Tree falling on
him (had cut tree down himself)
Date of onset: (blank)
Contributory causes: Cutting a tree
Name of operation: none
Accident, suicide, homicide: Accident
Date of Injury: 01 March 1938
Where did injury occur: in yard of home
Specify whether injury occurred industry, home, public place:
in his yard
Manner of injury: Cutting down tree
Nature of injury: Body mashed
Related to occupation: Yes
Signed/Address: R. D. Collins, M.D., Whitesburg, Ky.
Transcribed by Debbie Tamborski, 30 April 2010 |
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