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DEATH
CERTIFICATE
GEORGE MILLER
Date: 20 April 1951
Cert: 08305
Place of Death: County: Perry City or Town:
Ary
Length of stay (in this place): 01
Name of Hospital or Institution: Homeplace Clinic & Hospital
Usual Residence of Deceased: State: Kentucky County:
Breathitt
City or Town: Decoy Street Address: (blank)
Full Name: George MILLER
Date of Death: 20 April 1951
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 02 December 1900
Age: 50 years
Usual Occupation: Farmer
Kind of Industry or business: (blank)
Birthplace: Knott Co, Kentucky
Father's Name: Wood MILLER
Mother's Maiden Name: Polly FUGATE
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Mrs. George MILLER (wife)
Disease or condition directly leading to death: Rupture
of left (illegible) Artery
Due to: Hypertension
Interval between onset and death: 12 hours
Other significant conditions: Emphysema & bronchitis
Date of Operation: none
Major findings of operation: none
Autopsy: (blank)
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: Ary, Perry Co., Ky.
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 20 April 1951 to
20 April 1951, that I last saw the deceased alive on 20 April
1951, and
that death occurred at 7:35 a.m., from the causes and on the
date stated above.
Date signed: 20 April 1951
Address: Homeplace, Ary, Ky.
Signature: Ernest T. Anderson, M.D.
Burial, Cremation or Removal: Removal
Date: 1951
Name of Cemetery or Crematory: (blank)
Location: (blank)
Date received by local registrar: 29 (illegible) 1951
Registrar's Signature: Georgia P. Surer
Funeral director & address: (blank)
Transcribed by Debbie Tamborski, 23 July 2010 |
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