Date: 01 January 1941
Cert: 02308
Place of Death: County: Knott City or
Town: Lackey, Ky.
Name of Hospital or Institution: Stumbo Memorial Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Floyd
City or Town: Wayland, Ky.
Full Name: Robert H. NEAL
If Veteran Name War: (blank)
Social Security No.: 400-09-5277
Sex, Color or Race, Marital Status: Male, Colored, Married
Husband or Wife of: Laura NEAL
Age of husband or wife if alive: 56 years
Birth date of deceased: 04 July 1882
Age: 58 years, 05 months, 26 days
Birthplace: Harrison Co., Ga.
Occupation: Miner
Industry or business: Elkhorn Coal Co.
Father Name: Robert NEAL
Father Birthplace: Ga.
Mother Maiden Name: Susan HALL
Mother Birthplace: Ga.
Informant: Laura NEAL, Wayland, Ky.
Burial Place: Wayland, Ky.
Date: 05 January 1941
Signature of funeral director: G. D. Ryan, Martin, Ky.
Date received by local registrar: 09 January 1941
Registrar's Signature: Macie Miller
Date of Death: 01 January 1941
I hereby certify that I attended deceased from 16 December
1940 to
01 January 1941, that I last saw him alive on 01 January 1940, and that death
occurred on the date stated above at 10:35 p.m.
Immediate cause of death: Pulmonary Tuberculosis
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: W. L. Stumbo, M.D., Martin, Ky.
Date signed: 03 January 1941
Transcribed by Debbie Tamborski, 14 October 2010 |