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DEATH
CERTIFICATE
SYLVIA PERKINS
Date 28 January 1941
Cert: 04368
Place of Death: County: Floyd City or Town:
Tram
Street No. or Location:
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County: Floyd
City or Town: Tram If rural give
precinct: Ivel 34
Full Name: Sylvia PERKINS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Widow
Husband or Wife of: William
Age of husband or wife if alive: (blank)
Birth date of deceased: 21 February 1860
Age: 79 years, 11 months, 24 days
Birthplace: Knott Co., Ky.
Occupation: house wife
Industry or business: (blank)
Father Name: Tom EVERIDGE
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Rachel JOHNSON
Mother Birthplace: Knott Co., Ky.
Informant: Hare AMBURGY, Tram, Ky.
Burial Place: Tram, Ky.
Date: 30 January 1941
Signature of funeral director: E. P. Arnold, Prestonsburg, Ky.
Date received by local registrar: 11 February 1941
Registrar's Signature: Mrs. Ben Norris
Date of Death: 28 January 1941
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw h-- alive on (blank), and that death
occurred on the date stated above at 4:45 p.m.
Immediate cause of death: Cerebral accident - Right
Duration: 02 days
Due to: Hypertensive Cardio Vascular Disease
Duration: 20 years
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: R. W. Allen, M.D., Harold, Ky.
Date signed: 11 February 1941
Transcribed by Debbie Tamborski, 13 May 2010 |
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