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DEATH
CERTIFICATE
DELORES OWENS
Date 19 August 1943
Cert: 22701
Place of Death: County: Johnson City or
Town: Paintsville, Ky.
Name of Hospital or Institution: Paintsville Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Garner, Ky. Rural
Full Name: Delores OWENS
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: 17 June 1942
Age: 01 years, 02 months, 02 days
Birthplace: Knott Co., Ky.
Occupation: Infant
Industry or business: (blank)
Father Name: Edward OWENS
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Gladys BATES
Mother Birthplace: Knott Co., Ky.
Informant: Dewey OWENS, Garner, Ky.
Burial Place: Garner
Date: 20 August 1943
Signature of funeral director: F. J. Conley, Paintsville
Date received by local registrar: 23 August 1943
Registrar's Signature: Gertrude Smedley, Johnson Co. H.
Dept.
Date of Death: 19 August 1943
I hereby certify that I attended deceased from 18 August 1943 to
19 August 1943, that I
last saw him alive on 19 August 1943, and that death occurred on the date
stated above at 8:32 a.m.
Immediate cause of death: Staphylococcus Aureus
Septicemia
Due to: Following im??? of (illegible)
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: Lon C. Hall, M.D., Paintsville, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 06 February 2010 |
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