Date: 27 November 1943
Cert: 14387
Place of Death: County: Knott City or
Town: Mallie, Ky., Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Mallie, Ky., Rural
Full Name: Canton Earl REYNOLDS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 18 March 1942
Age: 01 years, 08 months, 09 days
Birthplace: Knott Co., Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Cevester REYNOLDS
Father Birthplace: Pippapass
Mother Maiden Name: Mary MARTIN
Mother Birthplace: Pip (transcribed as written)
Informant: Cevester REYNOLDS, Pippapass, Ky.
Burial Place: Pippapass, Ky.
Date: 28 November 1943
Signature of funeral director: Isom Slone, Jr., Pippapass, Ky.
Date received by local registrar: 29 June 1943
Registrar's Signature: Ida Livingston
Date of Death: 27 November 1943
I hereby certify that I attended deceased from 02 November
1943 to
24 November 1943, that I last saw him alive on 24 November
1943, and that death occurred on the date stated above at 2
a.m.
Immediate cause of death: Broncho Pneumonia
Duration: 06 days
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: Mark Dempsey, M.D., Garrett, Ky.
Date signed: 20 April 1944
Transcribed by Debbie Tamborski, 25 October 2010 |