Date: 21 July 1944
Cert: 01590
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: Paul Everett MOORE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: Child
Age of husband or wife if alive: (blank)
Birth date of deceased: 19 July 1943
Age: 01 years, 00 months, 02 days
Birthplace: Mousie, Ky.
Occupation: None
Industry or business: (blank)
Father Name: Kelley MOORE
Father Birthplace: Handshoe, Ky.
Mother Maiden Name: Omey TRIPLETT
Mother Birthplace: Pippapass, Ky.
Informant: Omey MOORE, Mousie
Burial Place: Mousie, Ky.
Date: 22 July 1944
Signature of funeral director: Friends, Mousie, Ky.
Date received by local registrar: 22 January 1945
Registrar's Signature: Ida Livingston Rose B. Craft
Acting L. R.
Date of Death: 21 July 1944
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw h-- alive on 17 July 1944, and that
death occurred on the date stated above at 9:15 a.m.
Immediate cause of death: Enlarged liver & stomach
trouble
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
Date signed: 22 January 1945
Transcribed by Debbie Tamborski, 15 November 2010 |