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DEATH
CERTIFICATE
SUSAN MORRIS
Date: 25 February 1950
Cert: 05925
Place of Death: County: Morgan City or Town:
West Liberty
Length of stay (in this place): 01
Name of Hospital or Institution: West Liberty Hospital
Residence of Deceased: State: Kentucky County: Magoffin
City or Town: Bloomington Street Address: (blank)
Full Name: Susan MORRIS
Date of Death: 25 February 1950
Sex, Color or Race, Marital Status: Female, White,
(blank)
Date of Birth: 07 February 1864
Age: 86 years, 00 months, 18 days
Usual Occupation: Housewife
Kind of Industry or business: none
Birthplace: Knott Co., Kentucky
Father's Name: Robin WICKES
Mother's Maiden Name: Florence JACKSON
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Kelly B. MORRIS
Disease/condition directly leading to death: Pneumonia
Bilateral
Interval between onset and death: (blank)
Due to: (blank)
Other significant conditions: Cardiac Failure
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (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 23 February
1950 to
25 February 1950, that I last saw the deceased alive on 25
February 1950, and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: 27 February 1950
Address: West Liberty, Ky.
Signature: R. L. Gullett, M.D.
Burial, Cremation or Removal: Burial
Date: 26 February 1950
Name of Cemetery or Crematory: Family
Location: Bloomington, Kentucky
Date received by local registrar: 28 February 1950
Registrar's Signature: Louise Goble
Funeral director & address: H. D. Dotty, West
Liberty, Ky.
Transcribed by Debbie Tamborski, 15 July 2010 |
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