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NORTH CAROLINA STATE BOARD OF
HEALTH CERTIFICATE OF DEATH
WILLIAM RICHIE
Date: 24 March 1964
Cert: 07651
Place of Death: County: Cumberland
Township: Manchester
Length of stay (in this place): (blank)
City or Town: Fort Bragg
Name of Hospital or Institution: Womack Army Hospital
Usual Residence of Deceased: State: North Carolina
County: Cumberland City or Town: Spring Lake
Street Address: 2906 Brinkley Drive
Full Name: William RICHIE
Date of Death: 24 March 1964
Sex, Color or Race, Marital Status: Male, Cau., Married
Date of Birth: 07 February 1903
Age: 61 years
Usual Occupation: Miner
Kind of Industry or business: Mining
Birthplace: Knott County, Ky.
Father's Name: Josh RICHIE
Mother's Maiden Name: Nancy COMBS
Name of Husband or Wife: Winnie COMBS RICHIE
Was deceased ever in armed forces: No
Social Security No.: 403-01-0274
Informant: Winnie RICHIE, wife, 2906
Brinkley Dr., Sp. Lake, NC
Death was caused by: Coma
Interval between onset and death: 05 days
Due to (b): Cerebro vascular accident
Interval between onset and death: 06 days
Due to (c): Generalized Arteriosclerosis
Interval between onset and death: (blank)
Other significant conditions: Autopsy findings:
Perforated duodenal ulcer; infarction of cerebellum;
bronchlectasis; and bronchopneumonia
Autopsy: (blank)
Accident, suicide, or homicide: (blank)
Describe how injury occurred: (blank)
Time of injury: (blank)
Injury occurred at work: (blank)
Place of Injury: (blank)
I attended deceased from 20 March 1964 to
24 March 1964, that I last saw him alive on 24 March 1964.
Death occurred at 8:28 a.m., on the date stated above; and to
the best of my knowledge from the causes stated.
Signature: William V. Blazek, Capt. M. C.
Address: Womack Army Hospital, Fort Bragg, North
Carolina
Date signed: 24 March 1964
Burial, Cremation or Removal: Removal
Date: 26 March 1964
Name of Cemetery or Crematory: Breathitt Funeral Home
Location: Jackson, Ky.
Date received by local registrar: 26 March 1964
Registrar's Signature: M. T. Foster
Funeral director & address: Jernigan - Warren,
Fayetteville
Transcribed by Debbie Tamborski, 14 August 2010 |
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