|
DEATH
CERTIFICATE
CHARLIE NEAL
Date: 17 December 1940
Cert: 02304
Place of Death: County: Knott Co. City or Town:
Hanshoe, Ky.
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Knott Co.
City or Town: Hanshoe, Ky.
Full Name: Charlie NEAL
If Veteran Name War: (blank)
Social Security No.: 405-01-2109
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Maggie NEAL
Age of husband or wife if alive: 50 years
Birth date of deceased: 22 March 1885
Age: 55 years, 08 months, 25 days
Birthplace: Tennessee
Occupation: Miner
Industry or business: Central Elkhorn Coal Co.
Father Name: Henry NEAL
Father Birthplace: Tennessee
Mother Maiden Name: Minnie BARNS
Mother Birthplace: Tennessee
Informant/Address: Maggie NEAL, Hanshoe, Ky.
Burial Place: Garrett, Ky.
Date: 20 December 1940
Signature of funeral director/address: W. J. Ryan, Martin, Ky.
Date received by local registrar: 09 January 1941
Registrar's Signature: Macie Miller
Date of Death: 17 December 1940
I hereby certify that I attended deceased from May 1940 to 17
December 1940, that I last saw him alive on 17 December 1940,
and that death occurred on the date stated above at 6:45 p.m.
Immediate cause of death: Aortic aneurism
Duration: years
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: C. B. Ison, Garrett
Date signed: (blank)
Transcribed by Debbie Tamborski, 28 August 2010 |
|