Date 14 August 1954
Cert: # 18289
Place of Death: County: Knott
City or Town: Sassafras
Length of stay in hospital or community: (blank)
Name of Hospital or Institution:
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Sassafras
Full Name: W. T. McCormick
Date of Death: 14 August 1954
Sex, Color or Race, Marital Status: Male, White, married
Date of Birth: 22 October 1871
Age: 85
Usual Occupation: Peddler
Kind of Industry or business: (blank)
Birthplace: Arkansas
Father's Name: Not Listed
Mother's Maiden Name: Not Listed
Was deceased in ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Don Noble
Disease or condition directly leading to death: Carcinoma of
Prostate
Interval between onset and death: 2 years
Due to:
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings for operation: (blank)
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from Jan 1954 to 14
August 1954, that I last saw the deceased alive on 14 August
1954, and that death occurred at 3 PM the date stated above
at from the causes and on the date stated above.
Date signed: 26 August 1954
Address: Allock
Signature: A. b. Pigman, MD
Burial, Cremation or Removal: Burial
Date:16 August 1954
Name of Cemetery or Crematory: Mosley Cemetery
Location: Garner, KY
Date received by local registrar: 13 September 1954
Registrar's Signature: Myrtle Slone
Funeral director and address: John Everage ~ Hindman, KY
Transcribed by Gloria Marcum ~ 13 March 2010 |