Date: 14 June 1953
Cert: 17005
Place of Death: County: Knott
City or Town: Carrie, Ky. Rural
Length of stay (in this place): (blank)
Street address or location: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Carrie Rural If rural give
location:
(blank)
Full Name: Balis RITCHIE
Date of Death: 14 June 1953
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 22 July 1904
Age: 48 years, 11 months
Usual Occupation: Miner
Kind of Industry or business: Coal Mines
Birthplace: Perry Co., Ky.
Father's Name: William RITCHIE
Mother's Maiden Name: Rausia ASHLEY
Was deceased ever in armed forces: (blank)
Social Security No.: 407-16-1933
Informant: Mallie RITCHIE
Disease or condition directly leading to death: Self Inflicted
Shot Gun Decapitating Skull
Interval between onset and death: (blank)
Due to: (blank)
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 (blank) to
(blank), 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: 16 June 1953
Address: Hindman, Ky.
Signature: Jno. N. Taul, Coroner
Burial, Cremation or Removal: Burial
Date: (16 June 1953 marked thru)
Name of Cemetery or Crematory: (blank)
Location: (blank)
Date received by local registrar: 04 August 1953
Registrar's Signature: Rose B. Craft
Funeral director & address: John Everage, Hindman,
Ky.
Transcribed by Debbie Tamborski, 10 February 2011 |