Date: 08 June 1954
Cert: 26464
Place of Death: County: Knott
City or Town: Rural (Betty)
Length of stay (in this place): 05 (illegible)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky.
County: Floyd
City or Town: Garrett If rural give
location:
(blank)
Full Name: Beatrice SCOTT
Date of Death: 08 June 1954
Sex, Color or Race, Marital Status: Female, White, Widowed
Date of Birth: 01 October 1907
Age: 46 years
Usual Occupation: Housewife
Kind of Industry or business: Home
Birthplace: Ky.
Father's Name: Fred WILLIAMS
Mother's Maiden Name: Sallie COBURN
Was deceased ever in armed forces: No
Social Security No.: (blank)
Informant: (blank)
Disease or condition directly leading to death: Traumatic
injury to chest and broken neck
Interval between onset and death: (blank)
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: Accident
Place of injury: Highway
City or Town, County, State: Betty, Knott, Ky.
Time of Injury: 08 June 1954, 5 p.m.
Injury occurred at work: Not while at work
How did injury occur: Automobile Accident
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: 14 June 1954
Address: Lackey, Ky.
Signature: C. M. Aker, M.D.
Burial, Cremation or Removal: Burial
Date: 10 June 1954
Name of Cemetery or Crematory: Conly - Williams Cemetery
Location: Hueysville, Ky.
Date received by local registrar: 18 June 1954
Registrar's Signature: Mrs. Rose. B. Craft
Funeral director & address: John N. Taul, Hindman,
Ky.
Transcribed by Debbie Tamborski, 23 February 2011 |