|
DEATH
CERTIFICATE
BASIL CALVIN MESSER
Date: 22 April 1944
Cert: 12690
Place of Death: County: Perry City or Town:
Hazard
Street No. or Location: Highland Ave.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Perry
City or Town: Hazard
Full Name: Basil Calvin MESSER
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: 14 October 1896
Age: 47 years
Birthplace: Knott Co., Ky.
Occupation: Salesman
Industry or business: (blank)
Father Name: Flem D. MESSER
Father Birthplace: W. Va.
Mother Maiden Name: Cynthia RITCHIE
Mother Birthplace: Knott Co.
Informant: C. H. NOBLE, Hazard, Ky.
Burial Place: Allais
Date: 47 April 1944
Signature of funeral director: Engles, Hazard, Ky.
Date received by local registrar: 23 May 1944
Registrar's Signature: Anna L. Boulos
Date of Death: 22 April 1944
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Heart Failure
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: Ed H. Ivey, Coroner, P. C. Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 04 June 2010 |
|