Date: 29 May 1943
Cert: 11733
Place of Death: County: Knott City or
Town: (blank)
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: Rural
Full Name: Evie NOBLE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: (blank)
Age: 11 years, 03 months, 22 days
Birthplace: Breathitt Co., Ky.
Occupation: School girl
Industry or business: (blank)
Father Name: Bent NOBLE
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Chloea JOHNSON
Mother Birthplace: Breathitt Co., Ky.
Informant: Bud NOBLE, Vest, Ky.
Burial Place: (blank)
Date: (blank)
Signature of funeral director: (blank)
Date received by local registrar: 01 June 1943
Registrar's Signature: Ida Livingston
Date of Death: 29 May 1943
I hereby certify that I attended deceased from 01 January 1943 to
29 May 1943, that I last saw her alive on 04 April 1943, and
that death occurred on the date stated above at 11 a.m.
Immediate cause of death: Chronic Dilatation of the
heart
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: M. F. Kelley, Hindman
Date signed: 09 June 1943
Transcribed by Debbie Tamborski, 25 October 2010 |