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DEATH
CERTIFICATE
MR. JOHN ROULAND
Date 17 October 1937
Cert: 28892
Name: Mr. John ROULAND
Place of Death: Voting Pct. #19 Lackey, St. M.
Hosp., Knott Co., KY
Residence: Weeksbury, Ky.
Length of residence: (blank)
Male, White, Married
Husband or Wife of: (blank)
Birth Date: (blank)
Age: 33 years, 07 months, 22 days
Occupation: Miner
Place of Birth: Johnson Co.
Name of Father: Ornesteine ROULAND
Birthplace Father: Johnson Co.
Maiden Name of Mother: Laurine RATLIFF
Birthplace Mother: Johnson Co.
Informant: Ollie ROULAND, Weeksbury, Ky.
Death Date: 17 October 1937
Cause of Death: (?Tonlestia?) poisoning from gas fumes
Signed: W. L. Stumbo, M.D., Lackey, Ky.
Burial Place: Weeksbury, Ky.
Date of Burial: 19 October 1937
Undertaker: G. D. Ryan, Martin, Ky.
File Date: 23 November 1937
Registrar: Dr. G. C. Collins, D.D.S., Lackey, Ky.
Transcribed by Debbie Tamborski, 03 October 2009 |
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