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DEATH
CERTIFICATE
FARRIS MOORE, JR.
Date 29 July 1949
Cert: 16660
Place of Death: County: Johnson City or Town:
Length of stay in hospital or community: (blank)
Name of Hospital or Institution: Paintsville General
Hospital
Usual Residence of Deceased: State: Kentucky County: Knott
City or Town: Topmost
Full Name: Farris MOORE, Jr.
Date of Death: 29 July 1949
Sex, Color or Race, Marital Status: Male, White, Never married
Date of Birth: 12 February 1949
Age: 05 months, 17 days
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Lackey, Kentucky
Father's Name: Farris MOORE, Sr.
Mother's Maiden Name: Essie HALL
Was deceased in ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Farris MOORE
Disease or condition directly leading to death:
Dysentery
Interval between onset and death: (blank)
Due to: (blank)
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 28 July 1949 to
29 July 1949, that I
last saw the deceased alive on July 1949, and that death occurred on
the date stated above at 8:30 p.m., from the causes and on the date
stated above.
Date signed: 06 August 1949
Address: Paintsville, Ky.
Signature: Robert A. Hall, M.D.
Burial, Cremation or Removal: Burial
Date: 31 July 1949
Name of Cemetery or Creamatory: Hall / Cemetery
Location: Topmost, Ky.
Date received by local registrar: 09 August 1949
Registrar's Signature: Madge Salyer
Funeral director and address: G. D. Ryan, Martin, Ky.
Transcribed by Debbie Tamborski, 15 February 2010 |
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