Date: 08 July 1946
Cert: 15910
Place of Death: County: Knott City or
Town: Mallie, Ky. Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Mallie Rural
Full Name: Can MOORE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White,
Married
Husband or Wife of: Polly HOWARD MOORE
Age of husband or wife if alive: 61 years
Birth date of deceased: 17 May 1875
Age: 71 years, 01 months, 21 days
Birthplace: Floyd Co., Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: William MOORE
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Polly HOWARD
Mother Birthplace: Knott Co., Ky.
Informant: Ezzias SHORT
Burial Place: Craft Cemetery
Date: 10 July 1946
Signature of funeral director: Mason Moore (not
undertaker), Mousie, Ky.
Date received by local registrar: 30 July 1946
Registrar's Signature: Mrs. Rose B. Craft
Date of Death: 08 July 1946
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: Carcinoma of Liver
Duration: (blank)
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: J. W. Duke, M.D., Hindman, Ky.
Date signed: 30 July 1946
Transcribed by Debbie Tamborski, 14 December 2010 |