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DEATH
CERTIFICATE
NOAH MOORE
Date 22 September 1930
Cert: 23446
Place of Death: Voting Pct: #1, M. E. Hospital, Pike
Co., Ky.
Full Name: Noah Moore
Residence: Hueysville, Ky.
Length of Residence in city where death occurred:
(blank)
Sex, Color or Race, Marital Status: Male, White, Married
Ky.
Husband or Wife of: Lila MOORE
Date of Birth: (blank)
Age: 25 years
Occupation: Farming
Birthplace: Knott County, Ky.
Father Name: Newton MOORE
Birthplace Father: Floyd County, Ky.
Mother Maiden Name: Sarah CRAGER
Birthplace Mother: Floyd County, Ky.
Informant/Address: Newton MOORE, Hueysville, Ky.
Burial Cremation Removal Place: Hueysville, Ky.
Date: 24 September 1930
Undertaker/Address: J. W. Call, Pikeville, Ky.
Filed: 22 September 1930
Registrar: J. C. Wright
Death of Date: 22 September 1930
I hereby certify, That I attended deceased from (blank) to
(blank), that I last saw h-- alive on (blank), death is said
to have occurred on the date stated above, at (blank)
Cause of Death: Peritonitis (Gen'l)
Date of onset: (blank)
Contributory causes: Operated on for appendicitis
Name of operation: (blank)
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Specify where injury occurred: (blank)
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: (blank)
Signed/Address: M.D. Flanary, M.D., Pikeville, Ky.
Transcribed by Debbie Tamborski, 29 March 2010 |
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