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DEATH
CERTIFICATE
MARY RITCHIE
Date 22 February 1942
Cert: 12351
Place of Death: County: Perry City or Town:
Hazard
Name of Hospital or Institution: Hazard Hospital Co.
Length of stay in hospital or community:
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Anco
Full Name: Mary RITCHIE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: (blank)
Age: 14 days
Birthplace: Anco, Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: I. B. RITCHIE
Father Birthplace: Anco
Mother Maiden Name: Martha RITCHIE
Mother Birthplace: Ball
Informant: I. B. RITCHIE, Anco, Ky.
Burial Place: Second Creek
Date: 22 February 1942
Signature of funeral director: Family
Date received by local registrar: 29 April 1942
Registrar's Signature: Anna L. (illegible)
Date of Death: 22 February 1942
I hereby certify that I attended deceased from 21 February
1942 to 22 February 1942, that I
last saw her alive on 22 February 1942, and that death occurred on the date
stated above at 6:00 p.m.
Immediate cause of death: Bronchial pneumonia
Due to: (blank)
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: Chris S. Jackson, M.D., Hazard, Ky.
Date signed: 24 February 1942
Transcribed by Debbie Tamborski, 05 February 2010 |
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