Date: 09 February 1946
Cert: 06991
Place of Death: County: Knott City or
Town: Mousie, 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: Mousie Rural
Full Name: Marvin MOORE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White,
Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 08 May 1945
Age: 09 months, 01 days
Birthplace: Mousie, Knott Co., Ky.
Occupation: None
Industry or business: (blank)
Father Name: Kelly MOORE
Father Birthplace: Handshoe, Ky.
Mother Maiden Name: Omey TRIPLETT
Mother Birthplace: Pippapass
Informant: Omey MOORE, Mousie, Ky.
Burial Place: Mousie
Date: 10 February 1946
Signature of funeral director: Grover & Clifton Moore
(not undertakers), Mousie, Ky.
Date received by local registrar: 28 March 1946
Registrar's Signature: Mrs. Rose. B. Craft
Date of Death: 09 February 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: Pneumonia
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: 28 March 1946
Transcribed by Debbie Tamborski, 14 December 2010 |