Date: 29 April 1942
Cert: 11887
Place of Death: County: Knott City or
Town: Hindman
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: (blank)
City or Town: (blank)
Full Name: Nancy Narcisse PERKINS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White
Husband or Wife of: Henry PERKINS
Age of husband or wife if alive: (blank)
Birth date of deceased: 06 January 1860
Age: 82 years, 03 months, 23 days
Birthplace: Grayson Co., Virginia
Occupation: House Keeping
Industry or business: (blank)
Father Name: Major PUGH
Father Birthplace: Virginia
Mother Maiden Name: Charlotte
Mother Birthplace: Virginia
Informant: Lyda MADDEN, Hindman, Ky.
Burial Place: Perkins Branch
Date: 01 May 1942
Signature of funeral director: Lyda Madden, Hindman, Ky.
Date received by local registrar: 08 June 1942
Registrar's Signature: Ida Livingston
Date of Death: 29 April 1942
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Pneumonia
Duration: (blank)
Due to: Cold
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: J. W. Duke, M.D., Hindman
Date signed: 08 June 1942
Transcribed by Debbie Tamborski, 17 October 2010 |