|
DEATH
CERTIFICATE
KATIE MILLER
Date 04 January 1950
Cert: 06052
Place of Death: County: Perry City or Town:
Hazard
Length of stay in hospital or community:
Name of Hospital or Institution: Hurst Snyder
Usual Residence of Deceased: State: Ky. County: Knott
City or Town: Amburgy
Full Name: Katie MILLER
Date of Death: 04 January 1950
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 03 March 1895
Age: 63 years, 10 months, 01 days
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Tenn.
Father's Name: William DEAL
Mother's Maiden Name: Elizabeth PEVLEY
Was deceased in ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Malcalm MILLER
Disease or condition directly leading to death:
Decompensation
Interval between onset and death: (blank)
Due to: Hypertension
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings for operation: (blank)
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 02 January 1950 to
04 January 1950, that I
last saw the deceased alive on 04 January 1950, and that death occurred on
the date stated above at 4:00 p.m., from the causes and on the date
stated above.
Date signed: 09 January 1950
Address: Hazard, Ky.
Signature: D. R. (illegible) M.D.
Burial, Cremation or Removal: Burial
Date: 07 January 1950
Name of Cemetery or Creamatory: Spencer
Location: Knott Co., Ky.
Date received by local registrar: 23 March 1950
Registrar's Signature: Georgia Pendleton
Funeral director and address: Engle's, Hazard, Ky.
Transcribed by Debbie Tamborski, 16 February 2010 |
|