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DEATH
CERTIFICATE
FRENCH MILLER
Date: 30 June 1947
Cert: 16452
Place of Death: County: Perry City or Town:
Allias
Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Perry
City or Town: Blue Diamond
Full Name: French MILLER
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Bell MILLER
Age of husband or wife if alive: 37 years
Birth date of deceased: 1906
Age: 41 years, months, days
Birthplace: Knott
Occupation: Miner
Industry or business: (blank)
Father Name: Tom MILLER
Father Birthplace: Breathitt
Mother Maiden Name: Polly GRIGSBY
Mother Birthplace: Knott
Informant: Mrs. French MILLER, Blue Diamond, Ky.
Burial Place: Bonnyman
Date: 01 July 1947
Signature of funeral director: Engle's, Hazard, Ky.
Date received by local registrar: 12 July 1947
Registrar's Signature: Pearl G. Combs
Date of Death: 30 June 1947
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: Shock
Duration: (blank)
Due to: Gun shot in left shoulder & head
Major findings of operations: (blank)
Accident, suicide, or homicide: Homicide
Date of occurrence: (blank)
Where did injury occur: (illegible) camp at Allias
While at work: (blank)
Means of injury: (blank)
Signature & Address: (illegible), M.D., Hazard, Ky.
Date signed: 17 July 1947
Transcribed by Debbie Tamborski, 24 June 2010 |
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