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DEATH
CERTIFICATE
PAULINE RUSSELL
Date 20 January 1952
Cert: 03671
Place of Death: County: Perry City or Town:
Ary
Length of stay in hospital or community:
Name of Hospital or Institution: Homeplace Hospital
Usual Residence of Deceased: State: Kentucky County: Knott
City or Town: Vest
Full Name: Pauline RUSSELL
Date of Death: 20 January 1952
Sex, Color or Race, Marital Status: Female, White, Widowed
Date of Birth: 02 November
Age: 53 years
Usual Occupation: Hswk.
Kind of Industry or business: (blank)
Birthplace: Breathitt Co., Ky.
Father's Name: William RUSSELL
Mother's Maiden Name: Tilda RITCHIE
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Daughter - Mrs. Maudie FUGATE
Disease or condition directly leading to death:
Pulmonary Edema
Interval between onset and death: 01 months
Due to: Hypertensive cardiovascular disease
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (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 14 January 1952 to
20 January 1952, that I
last saw the deceased alive on 20 January 1952, and that death occurred on
the date stated above at 4:45 a.m., from the causes and on the date
stated above.
Date signed: 20 January 1952
Address: Ary, Ky.
Signature: K. W. Cameron, M.B. ChB
Burial, Cremation or Removal: (blank)
Date: (blank)
Name of Cemetery or Creamatory: (blank)
Location: (blank)
Date received by local registrar: 02 February 1952
Registrar's Signature: George P. Surer
Funeral director and address: (blank)
Transcribed by Debbie Tamborski, 20 February 2010 |
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