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DEATH
CERTIFICATE
JOHN MOSLEY
Date 20 July 1936
Cert: 18608
Place of Death: Voting Pct.: Beaver Valley Hosp.,
Martin, Floyd Co., Ky.
Full Name: John MOSLEY
Residence: Leburn, Ky.
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Date of Birth: not known
Age: 19 years
Occupation: Farmer
Birthplace: Knott Co., Ky.
Father Name: L. D. MOSLEY
Birthplace Father: Floyd Co., Ky.
Mother Maiden Name: Josephine SHORT
Birthplace Mother: Knott Co.
Informant/Address: L. D. MOSLEY, Leburn, Ky.
Burial Cremation Removal Place: Leburn
Date: 21 July 1936
Undertaker/Address: Franklin W. Moore, Martin, Ky.
Filed: 01 August 1936
Registrar: W. M. Griffith
Death of Date: 20 July 1936
I hereby certify, That I attended deceased from 20 July 1936 to
(blank), that I last saw him alive on 20 July 1936, death is said
to have occurred on the date stated above, at (blank)
Cause of Death: Fracture base of skull contusion of
brain
Date of onset: 20 July 1936
Contributory causes: (blank)
Name of operation: (blank)
Accident, suicide, homicide: Accident
Date of Injury: 20 July 1936
Where did injury occur: Denwood, Ky., Floyd Co.
Specify whether injury occurred industry, home, public place:
Public Place
Manner of injury: Struck by train
Nature of injury: see above
Related to occupation: no
Signed/Address: J. R. Allen, M.D., Martin, Ky.
Transcribed by Debbie Tamborski, 21 April 2010 |
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