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DEATH
CERTIFICATE
BILL OLIVER
Date 17 July 1943
Cert: 18977
Place of Death: County: Perry City or
Town: Hazard
Name of Hospital or Institution: Hazard Hospital Co.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural Red Fox
Full Name: Bill OLIVER
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Marred
Husband or Wife of: Mattie OLIVER
Age of husband or wife if alive: 27 years
Birth date of deceased: 1904
Age: 29 years
Birthplace: Perry Co., Ky.
Occupation: Coal Miner
Industry or business: (blank)
Father Name: George OLIVER
Father Birthplace: Ky.
Mother Maiden Name: Polly FIELDS
Mother Birthplace: Ky.
Informant: Eli COUCH, Hazard, Ky.
Burial Place: Englewood
Date: 19 July 1943
Signature of funeral director: Engles, Hazard
Date received by local registrar: 29 July 1943
Registrar's Signature: Anna L. Boulas
Date of Death: 17 July 1943
I hereby certify that I attended deceased from 16 July 1943 to
17 July 1943, that I
last saw him alive on 17 July 1943, and that death occurred on the date
stated above at 7 p.m.
Immediate cause of death: Bacillary dysentery
Other Conditions: Dehydration, paralysis of body from
1st lumbar (illegible) due to mine injury 5 to 7 years ago
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: Chris S. Jackson, M.D., Hazard, Ky.
Date signed: 26 July 1943
Transcribed by Debbie Tamborski, 06 February 2010 |
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