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DEATH
CERTIFICATE
NOAH REYNOLDS
Date: 10 February 1940
Cert: 15462
Place of Death: County: Knott City or Town:
Pinetop
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Pinetop, Ky.
Full Name: Noah REYNOLDS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Widowed
Husband or Wife of: Ranie REYNOLDS
Age of husband or wife if alive: (blank)
Birth date of deceased: 02 March 1892
Age: 48 years
Birthplace: Knott Co., Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Joseph REYNOLDS
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Elizabeth SLONE
Mother Birthplace: Knott Co., Ky.
Informant/Address: Troy REYNOLDS, Hindman, Ky.
Burial Place: Reynolds Cemetery
Date: 11 February 1940
Signature of funeral director/address: (blank)
Date received by local registrar: 09 June 1941
Registrar's Signature: Macie Miller
Date of Death: 10 February 1940
I hereby certify that I attended deceased from 04 February
1940 to
(blank), that I last saw him alive on 04 February 1940, and that death
occurred on the date stated above at (blank)
Immediate cause of death: Pulmonary Tuberculosis
Duration: (blank)
Due to: (illegible)
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. W. Duke, M.D., Hindman, Ky.
Date signed: 09 June 1941
Transcribed by Debbie Tamborski, 28 August 2010 |
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