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DEATH
CERTIFICATE
ONA W. SCRUGGS
Date 03 August 1945
Cert: 17855
Place of Death: County: Perry Co. City or
Town: Hazard, Ky.
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: Sasfrass, Ky.
Full Name: Ona W. SCRUGGS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: Lee SCRUGGS
Age of husband or wife if alive: (blank)
Birth date of deceased: 28 February 1915
Age: 30 years, 05 months, 03 days
Birthplace: Knott Co.
Occupation: School Teacher
Industry or business: (blank)
Father Name: Woots WALLEN
Father Birthplace: Floyd Co.
Mother Maiden Name: Ida May VANCE
Mother Birthplace: Knott Co.
Informant: Lee SCRUGGS, Sasfrass, Ky.
Burial Place: Litt Carr, Knott Co.
Date: 05 August 1945
Signature funeral director: Maggard Funeral Home, Hazard, Ky.
Date received by local registrar: 30 August 1945
Registrar's Signature: Opsie J. Deaton
Date of Death: 03 August 1945
I hereby certify that I attended deceased from 02 June 1945 to
03 August 1945, that I
last saw him alive on 03 August 1945, and that death occurred on the date
stated above at 3:00 p.m.
Immediate cause of death: (illegible) septicemia
Due to: Bacterial endocarditis
Other conditions: Mitral stenosis
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: 20 August 1945
Transcribed by Debbie Tamborski, 09 February 2010 |
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