Date: 02 January 1942
Cert: 07074
Place of Death: County: Knott City or
Town: Raven
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: Raven
Full Name: Woodroe REYNOLDS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Margaret REYNOLDS
Age of husband or wife if alive: 49 years
Birth date of deceased: 18 November 1913
Age: 28 years, 01 months, 15 days
Birthplace: Hindman, Knott Co., Ky.
Occupation: Miner
Industry or business: Coal
Father Name: William REYNOLDS
Father Birthplace: Ky., Knott Co.
Mother Maiden Name: Frankie Jane SLONE
Mother Birthplace: Pippapass, Knott Co., Ky.
Informant: Elijah OWENS, Pippapass, Ky.
Burial Place: Raven
Date: 03 January 1942
Signature of funeral director: Elijah Owens, Pippapass, Ky.
Date received by local registrar: (blank)
Registrar's Signature: (blank)
Date of Death: 02 January 1942
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at 4:30 p.m.
Immediate cause of death: Homicide Shotgun wounds in
neck, chest & side
Duration: (blank)
Due to: no Doctor was called
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: (blank)
Date signed: (blank)
Transcribed by Debbie Tamborski, 18 October 2010 |