Date: 13 August 1947
Cert: 20402
Place of Death: County: Knott City or
Town: Hindman, Ky. Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Hindman Street
No.: Rural
Full Name: Mrs. Jennie EVERAGE NEWLAND
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Widowed
Husband or Wife of: Robert NEWLAND
Age of husband or wife if alive: (blank)
Birth date of deceased: 14 December 1860
Age: 86 years, 07 months, 29 days
Birthplace: Kentucky
Occupation: Housewife
Industry or business: (blank)
Father Name: Solomon EVERAGE
Father Birthplace: Kentucky
Mother Maiden Name: Betsy TURNER
Mother Birthplace: Kentucky
Informant: Dan PRATER, Hindman, Ky.
Burial Place: Amburgey Cem., Hindman
Date: 14 August 1947
Signature of funeral director: Friends & Relatives,
Hindman, Ky.
Date received by local registrar: 13 September 1947
Registrar's Signature: Rose B. Craft
Date of Death: 13 August 1947
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Heart Failure
Duration: (blank)
Due to: Arteriosclerosis
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: J. W. Duke, M.D., Hindman, Ky.
Date signed: 13 September 1947
Transcribed by Debbie Tamborski, 18 December 2010 |