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DEATH
CERTIFICATE
WILLIAM OWENS
Date 12 October 1939
Cert: 24694
Place of Death: County: Floyd
City or Town: Martin
Name of Hospital or Institution: Beaver Valley Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Floyd
City or Town: Hunter
Full Name: William OWENS
If Veteran Name War: (blank)
Social Security No.: 400-16-9186
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Alta OWENS
Age of husband or wife if alive: (blank)
Birth date of deceased: 06 June 1904
Age: 35 years, 04 months, 06 days
Birthplace: Knott Co.
Occupation: Labor
Industry or business: (blank)
Father Name: Rusil OWENS
Father Birthplace: Knott Co.
Mother Maiden Name: Rose OWENS
Mother Birthplace: Knott Co.
Informant: Alta OWENS, Hunter, Ky.
Burial Place: Hunter, Ky.
Date: 14 October 1939
Signature of funeral director: G. D. Ryan, Martin, Ky.
Date received by local registrar: 15 October 1939
Registrar's Signature: Mrs. Ben Norris
Date of Death: 12 October 1939
I hereby certify that I attended deceased from 12 October 1939
to 12 October 1939, that I last saw him alive on 12 October
1939, and that death occurred on the date stated above at 7:00
p.m.
Immediate cause of death: Cerebral Hemorrhage
Duration: (blank)
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. L. Stumbo, M.D., Martin, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 05 May 2010 |
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