Date: 09 March 1944
Cert: 07538
Place of Death: County: Knott City or
Town: Rural
Street Number or Location: Mallie
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural If rural,
give precinct: Mallie, Ky.
Full Name: Humphery REYNOLDS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Verda REYNOLDS
Age of husband or wife if alive: 20 years
Birth date of deceased: 17 July 1920
Age: 23 years, 07 months, 22 days
Birthplace: Knott Co., Ky.
Occupation: Farmer
Industry or business: Farming
Father Name: Ira REYNOLDS
Father Birthplace: Ky.
Mother Maiden Name: Ora BOATRIGHT
Mother Birthplace: Ky.
Informant: Canton SLONE, Mallie, Ky.
Burial Place: Mallie
Date: 10 March 1944
Signature of funeral director: Engles, Hazard, Ky.
Date received by local registrar: 16 March 1944
Registrar's Signature: Ida Livingston
Date of Death: 09 March 1944
I hereby certify that I attended deceased from (blank) to
10 December 1943, that I last saw him alive on 06 February
1944, and that death occurred on the date stated above at 9
p.m.
Immediate cause of death: Tuberculosis of the lungs
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: M. F. Kelley, M.D., Hindman, Ky.
Date signed: 15 March 1944
Transcribed by Debbie Tamborski, 22 November 2010 |