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DEATH
CERTIFICATE
FLORENCE OSBORNE
Date 16 January 1942
Cert: 03248
Place of Death: County: Floyd City or Town:
Wheelwright
Street No. or Location: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County: Floyd
City or Town: Rural Melvin If
rural give Precinct: 40
Full Name: Florence OSBORNE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: John OSBORNE
Age of husband or wife if alive: 83 years
Birth date of deceased: 03 April 1865
Age: 76 years, 09 months, 13 days
Birthplace: Knott Co.
Occupation: Housewife
Industry or business: (blank)
Father Name: Harve JOHNSON
Father Birthplace: unknown (Floyd Co.) [sic]
Mother Maiden Name: Liza COOK
Mother Birthplace: Knott Co.
Informant: W. M. OSBORNE, Melvin, Ky.
Burial Place: Osborne Cemetery
Date: 17 January 1942
Signature of funeral director: J. D. Malone, Bypro, Ky.
Date received by local registrar: (blank)
Registrar's Signature: (blank)
Date of Death: 16 January 1942
I hereby certify that I attended deceased from 10 May 1941 to
15 January 1942, that I last saw her alive on 15 January 1942,
and that death occurred on the date stated above at 1:30 a.m.
Immediate cause of death: Myocarditis
Duration: (illegible)
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. D. Osborne, M.D., Bypro
Date signed: 16 January 1942
Transcribed by Debbie Tamborski, 26 May 2010 |
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