Date: 01 June 1941
Cert: 22640
Place of Death: County: Knott City or
Town: Leburn, Ky.
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: (blank)
County: (blank)
City or Town: (blank)
Full Name: Stella OWNS
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: 10 June 1941 (transcribed as
written)
Age: 24 years, 00 months, 14 days
Birthplace: Knott
Occupation: School girl
Industry or business: (blank)
Father Name: John OWNS
Father Birthplace: Ky.
Mother Maiden Name: Hellen SLONE
Mother Birthplace: Ky.
Informant: Hellen OWNS, Leburn, Ky.
Burial Place: Dyer Cemetery
Date: 11 June 1941
Signature of funeral director: Hellen Owns, Leburn, Ky.
Date received by local registrar: 11 September 1941
Registrar's Signature: Phena Slone
Date of Death: 01 June 1941
I hereby certify that I attended deceased from 01 June 1941 to
10 June 1941, that I last saw h-- alive on 01 June 1941, and
that death occurred on the date stated above at 2 p.m.
Immediate cause of death: Tuberculosis
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: M. F. Kelley, M.D., Hindman, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 14 October 2010 |