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DEATH
CERTIFICATE
Mrs. FLORA PEDDICORD
Date: 24 January 1943
Cert: 02299
Place of Death: County: Perry City or Town:
Hazard
Hospital or Institution: Hazard Hospital Co.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Perry
City or Town: Hazard, Ky.
Full Name: Mrs. Flora PEDDICORD
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: H. C. PEDDICORD
Age of husband or wife if alive: 48
Birth date of deceased: (blank)
Age: 49 years
Birthplace: Knott Co., Ky.
Occupation: Housewife
Industry or business: (blank)
Father Name: Leander KELLY
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Elizabeth CORNETT
Mother Birthplace: Knott Co., Ky.
Informant: H. C. PEDDICORD, Hazard, Ky.
Burial Place: Ary
Date: 26 January 1943
Signature of funeral director: Engle Und. &
Hdwe. Co., Hazard, Ky.
Date received by local registrar: 30 January 1943
Registrar's Signature: Anna L. Boulos
Date of Death: 24 January 1943
I hereby certify that I attended deceased from 01 January 1943 to
24 January 1943, that I last saw him alive on 24 January 1943,
and that death occurred on the date stated above at 3:30 p.m.
Immediate cause of death: 2 degree burns of 60% body
(illegible)
Duration: 05 weeks
Due to: (blank)
Other conditions: Cancer of cervix with (illegible)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: Chris S. Jackson, M.D., Hazard,
Ky.
Date signed: 30 January 1943
Transcribed by Debbie Tamborski, 01 June 2010 |
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