Date: 09 November 1946
Cert: 24392
Place of Death: County: Knott City or
Town: Tina
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Tina
Full Name: David K. SHEPHERD
If Veteran Name War: World War II
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 15 September 1918
Age: 28 years,01 months, 24 days
Birthplace: West, Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: William SHEPHERD
Father Birthplace: Ky.
Mother Maiden Name: Renda NAPIER
Mother Birthplace: Ky.
Informant: Willie WALTERS, Hardburley, Ky.
Burial Place: Tina Cem.
Date: 11 November 1946
Signature of funeral director: Engle's, Hazard, Ky.
Date received by local registrar: 24 November 1946
Registrar's Signature: Mrs. Rose B. Craft
Date of Death: 09 November 1946
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Burned to death
Duration: (blank)
Due to: Home in which man was sleeping burned.
Major findings of operations: (blank)
Accident, suicide, or homicide: Accident
Date of occurrence: 09 November 1946
Where did injury occur: In his home
While at work: No
Means of injury: Fire
Signature & Address: J. W. Duke, M.D., Hindman, Ky.
Date signed: 30 November 1946
Transcribed by Debbie Tamborski, 14 December 2010 |