Date: 11 November 1956
Cert: # 56-25984
Place of Death: County: Knott City or Town: Handshoe -
Rural
Length of stay (in this place): (blank)
Full Name of Hospital or Institution: none
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Handshoe
Rural
Street Address: (blank)
Full Name: Grover Cleveland MESSER
Date of Death: 11 November 1956
Sex, Color or Race, Marital Status: Male, White,
Married
Date of Birth: 19 February 1889
Age: 69 years
Usual Occupation: (blank)
Kind of Industry or business: Merchant
Birthplace: Ky.
Father's Name: Lige MESSER
Mother's Maiden Name: Sally MAGGARD
Was deceased ever in armed forces: (blank)
Social Security No.: XXX-XX-XXX
Informant: Herbit MESSER
Disease/condition directly leading to death: Coronary
occlusion
Interval between onset and death: (blank)
Due to: (blank)
Other significant conditions: Collapsed while reaching up on
high shelf in grocery. Died instantly.
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Describe how injury occurred: (blank)
Time of injury: (blank)
Injury occurred at work: (blank)
Place of injury: (blank)
City, Town or Location, County, State: (blank)
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw the deceased alive on (blank), and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: 03 December 1956
Address: Prestonsburg, Ky.
Signature: John Sizemore, M.D., Floyd County Health
Dept. Clinician
Burial, Cremation or Removal: Burial
Date: 1956
Name of Cemetery or Crematory: Handshoe Cemetery
Location: Handshoe, Ky.
Date received by local registrar: 21 December 1956
Registrar's Signature: Myrtle Slone
Funeral director & address: Turner & Ryan Funeral
Home, Martin, Ky.
Transcribed by Debbie Tamborski, 26 April 2012 |