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DEATH
CERTIFICATE
BOON OLIVER
Date: 23 May 1940
Cert: 12875
Place of Death: County: Knott Co. 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:
Knott
City or Town: Lackey, Ky. Street
No.: Rural
Full Name: Boon OLIVER
If Veteran Name War: (blank)
Social Security No.: 408-12-6865
Sex, Color or Race, Marital Status: Male, White, Widowed
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 08 June 1883
Age: 58 years, 11 months, 15 days
Birthplace: Breathitt Co.
Occupation: Carpenter
Industry or business: Central Elkhorn Coal Co.
Father Name: Lee OLIVER
Father Birthplace: Breathitt Co.
Mother Maiden Name: Rettie OLIVER
Mother Birthplace: Breathitt Co.
Informant/Address: Monre OLIVER, Lackey, Ky.
Burial Place: Lambrick, Ky.
Date: 24 May 1940
Signature of funeral director/address: G. D. Ryan, Martin, Ky.
Date received by local registrar: 27 May 1940
Registrar's Signature: Macie Miller
Date of Death: 23 May 1940
I hereby certify that I attended deceased from 22 May 1940 to
23 May 1940, that I last saw him alive on 23 May 1940, and
that death occurred on the date stated above at 11 a.m.
Immediate cause of death: Cerebral hemorrhage (apoplexy)
Duration: (blank)
Due to: Hypertension
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: Edward (illegible), M.D.,
Lackey, Ky.
Date signed: 23 May 1940
Transcribed by Debbie Tamborski, 28 August 2010 |
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