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DEATH
CERTIFICATE
Mrs. CURTIS RICHARDSON
Date 13 July 1943
Cert: 18975
Place of Death: County: Perry City or
Town: Hazard
Name of Hospital or Institution: Hazard Hospital Co.
Length of stay in hospital or community: 05 days
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Spider Rural
Full Name: Mrs. Curtis RICHARDSON
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: Curtis RICHARDSON
Age of husband or wife if alive: 41 years
Birth date of deceased: 15 December 1902
Age: 40 years
Birthplace: Knott Co., Ky.
Occupation: Housewife
Industry or business: (blank)
Father Name: Ambrose AMBURGEY
Father Birthplace: Knott Co.
Mother Maiden Name: Nancy SMITH
Mother Birthplace: Knott Co.
Informant: Mrs. Maude LAWHORN, Pikeville
Burial Place: Spider
Date: 14 July 1943
Signature of funeral director: Engles, Hazard, Ky.
Date received by local registrar: 29 July 1943
Registrar's Signature: Anna L. Boulos
Date of Death: 13 July 1943
I hereby certify that I attended deceased from 08 July 1943 to
08 July 1943, that I
last saw him alive on 08 July 1943, and that death occurred on the date
stated above at 1 a.m.
Immediate cause of death: Peritonitis
Due to: Ruptured appendix
Major findings of operations: Ruptured appendix & peritonitis
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature: Chris S. Jackson, M.D., Hazard, Ky.
Date signed: 20 July 1943
Transcribed by Debbie Tamborski, 06 February 2010 |
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