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DEATH
CERTIFICATE
Mrs. HOWARD MULLEN
Date 20 November 1941
Cert: 10015
Place of Death: County: Perry City or Town:
Rural
Name of Hospital or Institution: Hazard Hospital
Length of stay in hospital or community: 24 hours
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Sassafras
Full Name: Mrs. Howard MULLEN
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: M, W, Married
Husband or Wife of: Howard MULLINS
Age of husband or wife if alive: 69
Birth date of deceased: 28 April 1889
Age: 52 years, 06 months, 22 days
Birthplace: Knott Co., Ky.
Occupation: House Keeping
Industry or business: (blank)
Father Name: (blank)
Father Birthplace: (blank)
Mother Maiden Name: Sinda ASHLEY
Mother Birthplace: Knott Co., Ky.
Informant: Howard MULLINS, Amburgey, Ky.
Burial Place: Mullins Cem.
Date: 22 November 1941
Signature of funeral director: Bishup, Hazard, Ky.
Date received by local registrar: 10 December 1941
Registrar's Signature: Anna Laura Bando
Date of Death: 20 November 1941
I hereby certify that I attended deceased from 19 November
1941 to 20 November 1941, that I
last saw him alive on 20 November 1941, and that death occurred on the date
stated above at 8 p.m.
Immediate cause of death: Apendecitis, diffuse peritonitis
Due to: Paralytic (illegible) Other
Conditions: (illegible) of peritonitis in abdomen
Major findings of operations: non
Accident, suicide, or homicide: Apendecitis
Date of occurrence: 18 November 1941
Where did injury occur: Home
While at work: Yes
Means of injury: Straine
Signature: Chris S. Jackson, M.D., Hazard, Ky.
Date signed: 22 November 1941
Transcribed by Debbie Tamborski, 01 February 2010 |
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