Date: 29 October 1949
Cert: 23446
Place of Death: County: Knott
City or Town: Sassafras
Length of stay (in this place): (blank)
Name of Hospital or Institution: None
Usual Residence of Deceased: State: Ky.
County: Perry
City or Town: Sassafras Street Address:
(blank)
Full Name: Ivory PERKINS
Date of Death: 29 October 1949
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 26 April 1898
Age: 51 years
Usual Occupation: Housewife
Kind of Industry or business: Home
Birthplace: Knott County, Ky.
Father's Name: James COLLINS
Mother's Maiden Name: Martha PARKS
Was deceased ever in armed forces: No
Social Security No.: None
Informant: Edgar PERKINS
Disease/condition directly leading to death: Anemia, Secondary
Interval between onset and death: 01 year
Due to: Malnutrition
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: Sassafras, Knott, Ky.
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 04 January 1949 to
29 October 1949, that I last saw the deceased alive on 29
October 1949, and
that death occurred at 7 p.m., from the causes and on the
date stated above.
Date signed: 05 November 1949
Address: Allock, Ky.
Signature: A. B. Pigman, M.D.
Burial, Cremation or Removal: Burial
Date: 31 October 1949
Name of Cemetery or Crematory: Cornett Hill Cem.
Location: Sassafras, Ky.
Date received by local registrar: 09 November 1949
Registrar's Signature: Rose B. Craft
Funeral director & address: Maggard & Garrett, Hazard, Ky.
Transcribed by Debbie Tamborski, 08 January 2011 |