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DEATH
CERTIFICATE
GEORGE ROBERTS
Date 13 May 1934
Cert: 12849
Place of Death: Voting Pct.: No. 25, Hazard Hospital,
Hazard, Perry Co., Ky.
Full Name: George ROBERTS
Residence: Blue Diamond, Ky.
Length of Residence: 03 months
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Date of Birth: 15 September 1897
Age: 33 years, 07 months, 28 days
Occupation: Miner load coal
Birthplace: Knott County, Ky.
Father Name: Green ROBERTS
Birthplace Father: Kentucky
Mother Maiden Name: Peggy WALTERS
Birthplace Mother: Ky.
Informant/Address: Green ROBERTS, Combs, Ky.
Burial Cremation Removal Place: Clay Hole, Ky.
Date: 14 May 1934
Undertaker/Address: H. Engle, Hazard, Ky.
Filed: 22 May 1934
Registrar: J. P. Boggs
Death of Date: 13 May 1934
I hereby certify, That I attended deceased from 12 May 1934 to
13 May 1934, that I last saw him alive on 13 May 1934, death
is said to have occurred on the date stated above, at 2:30
a.m.
Cause of Death: Ruptured duodenal ulcer - peritonitis
Date of onset: (blank)
Contributory causes: Duodenal ulcer
Name of operation: Laparotomy
Date of: 12 May 1934
What test confirmed diagnosis: (blank)
Was there an autopsy: No
Specify whether injury occurred industry, home, public place:
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: No
Signed/Address: J. E. Hagan, M.D., Hazard, Ky.
Transcribed by Debbie Tamborski, 16 April 2010 |
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