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DEATH
CERTIFICATE
JOHN D. OWENS
Date 29 September 1947
Cert: 28900
Place of Death: County: Perry City or
Town: Hazard, Ky.
Name of Hospital or Institution: Hurst - Snyder Hospital
Length of stay in hospital or community: 01 days
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Sassafras, Ky.
Full Name: John D. OWENS
If Veteran Name War: None
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Annie OWENS
Age of husband or wife if alive: 53 years
Birth date of deceased: 25 December 1882
Age: 64 years, 09 months, 04 days
Birthplace: Knott County, Ky.
Occupation: Merchant
Industry or business: Store
Father Name: John OWENS
Father Birthplace: Knott County, Ky.
Mother Maiden Name: Christine ? (transcribed as written)
Mother Birthplace: Virginia
Informant: Corna COOK, Sassafras, Ky.
Burial Place: Amburgey, Ky.
Date: 1947
Signature funeral director: Maggard-Blair & Garrett, Hazard,
Ky.
Date received by local registrar: 10 January 1948
Registrar's Signature: Cleata D. Cox
Date of Death: 29 September 1947
I hereby certify that I attended deceased from 29 September
1947 to
29 September 1947, that I
last saw him alive on (blank), and that death occurred on the date
stated above at 3 p.m.
Immediate cause of death: Circulatory collapse due to
shock from crushing injury of chest (struck by (illegible).
Fractured ribs & Hemothorax
Other Conditions: Fracture of Rt. Tibia, Fibula, Ulna,
Radius
Major findings of operations: (blank)
Accident, suicide, or homicide: accident
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: Truck
Signature: C. R. Faulkner, M.D., Hazard, Ky.
Date signed: 07 October 1947
Transcribed by Debbie Tamborski, 12 February 2010 |
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