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DEATH
CERTIFICATE
BILL MAY
Date: 28 December 1940
Cert: 29238
Place of Death: County: Knott City or Town:
Dema (rural)
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Dema
Full Name: Bill MAY
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Dale MAY
Age of husband or wife if alive: 73 years
Birth date of deceased: 10 May 1865
Age: 75 years, 08 months
Birthplace: Elliot Co., Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Jim MAY
Father Birthplace: Elliot Co.
Mother Maiden Name: Margarette SLUSHER
Mother Birthplace: Elliot Co.
Informant/Address: M. C. ELKINS, Wheelwright, Ky.
Burial Place: Melvin, Ky.
Date: 30 December 1940
Signature of funeral director/address: J. L. Malone, Bypro,
Ky.
Date received by local registrar: 31 December 1940
Registrar's Signature: Macie Miller
Date of Death: 28 December 1940
I hereby certify that I attended deceased from 12 December
1940 to
28 December 1940, that I last saw him alive on 28 December
1940, and that death
occurred on the date stated above at (blank)
Immediate cause of death: Bronchitis
Duration: (blank)
Due to: (blank)
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: M. M. Collins, M.D., Lackey, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 27 August 2010 |
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