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DEATH
CERTIFICATE
JOHN POTTER
Date 19 March 1935
Cert: 07521
Place of Death: Voting Pct.: Jackhorn, Letcher Co., Ky.
Full Name: John POTTER
Residence: Jackhorn, Ky.
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Male, White, Child
Husband or Wife of: (blank)
Date of Birth: (blank)
Age: 06 years
Occupation: None
Birthplace: Knott County, Ky.
Father Name: Ben POTTER, Jr.
Birthplace Father: Knott County, Ky.
Mother Maiden Name: Hanner HALL
Birthplace Mother: Kentucky
Informant/Address: George BENTLEY, Jackhorn, Ky.
Burial Cremation Removal Place: Knott County, Ky.
Date: 20 March 1935
Undertaker/Address: No
Filed: 20 March 1935
Registrar: Nerva B. Howard
Death of Date: 19 March 1935
I hereby certify, That I attended deceased from 15 March 1935 to
19 March 1935, that I last saw him alive on 19 March 1935, death is said
to have occurred on the date stated above, at 9 p.m.
Cause of Death: Septic infection from Jaw and Throat
(septicemia)
Date of onset: 16 March 1935
Contributory causes: Teeth & Gums
Name of operation: none
What tests confirmed diagnosis: Physical exam
Was there an autopsy: no
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: no
Signed/Address: Can M. Bentley, M.D., Neon, Ky.
Transcribed by Debbie Tamborski, 17 April 2010 |
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