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DEATH
CERTIFICATE
JERRY MILLER
Date 23 June 1938
Cert: 17776
Name: Jerry MILLER
Place of Death: Voting Pct. Lower Jones Fork #19, Stumbo
Hosp., Lackey, Knott Co., KY
Residence: Wayland, Ky.
Length of residence: 7 months
Male, White, Divorced
Husband or Wife of: Pearl Noble Miller
Birth Date: (blank)
Age: 30 years
Occupation: Miner
Place of Birth: Breathitt Co., Ky.
Name of Father: Tom MILLER
Birthplace Father: Knott Co.
Maiden Name of Mother: Polly GRIGSBY
Birthplace Mother: Knott Co.
Informant: Landon CLEMMONS, Clemmons, Ky.
Death Date: 23 June 1938
Cause of Death: Hurt in mines, fractured
dorsal & lumbar vertebrae
Signed: Philip Bress, M.D., Lackey, Ky.
Burial Place: Clemmons, Ky.
Date of Burial: 24 June 1938
Undertaker: G. D. Ryan, Martin, Ky.
File Date: 25 July 1938
Registrar: G. C. Collins, D.D.S., per B. Carns
Transcribed by Debbie Tamborski, 31 October 2009 |
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