Date: 05 October 1945
Cert: 21793
Place of Death: County: Knott City or
Town: Lackey, Ky.
Name of Hospital or Institution: Stumbo Mem. Hosp.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Lackey
Full Name: Patty Ann PLUMRIDGE
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: 15 January 1943
Age: 01 years, 08 months, 20 days
Birthplace: Detroit, Mich.
Occupation: (blank)
Industry or business: (blank)
Father Name: Cyrel PLUMRIDGE
Father Birthplace: Detroit, Mich.
Mother Maiden Name: Margie SAMMONS
Mother Birthplace: Floyd Co., Ky.
Informant: J. E. SAMMONS, Lackey, Ky.
Burial Place: Lackey, Ky.
Date: 06 October 1945
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: 22 October 1945
Registrar's Signature: Rose B. Craft
Date of Death: 05 October 1945
I hereby certify that I attended deceased from 05 October 1945 to
05 October 1945, that I last saw him alive on 05 October 1945, and that death
occurred on the date stated above at 12:00 p.m.
Immediate cause of death: (illegible) Diphtheria
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: J. A. Stumbo, M.D., Lackey, Ky.
Date signed: 22 October 1945
Transcribed by Debbie Tamborski, 29 November 2010 |