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DEATH
CERTIFICATE
ELLEN RICHIE
Date: 31 December 1949
Cert: 27730
Place of Death: County: (illegible) City or Town: Richie
Length of stay (in this place): (blank)
Name of Hospital or Institution: Home
Usual Residence of Deceased: State: Ky. County:
Perry
City or Town: Richie Street Address: (blank)
Full Name: Ellen RICHIE
Date of Death: 31 December 1949
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 06 March 1890
Age: 59 years, 09 months, 25 days
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: Knott Co., Ky.
Father's Name: Martin FULLER
Mother's Maiden Name: Nancy RICHIE
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Sam RICHIE
Disease or condition directly leading to death:
Hypertension
Interval between onset and death: 10 years
Due to: Nephritis
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 1940 to
1949, that I last saw the deceased alive on (blank), and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: (blank)
Address: Hazard, Ky.
Signature: R. L. Collins, M.D.
Burial, Cremation or Removal: Burial
Date: 01 January 1950
Name of Cemetery or Crematory: Richie Fuller
Location: Knott Co., Ky.
Date received by local registrar: 14 January 1950
Registrar's Signature: Georgia Pendleton
Funeral director & address: Engle's, Hazard, Ky.
Transcribed by Debbie Tamborski, 13 July 2010 |
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