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DEATH
CERTIFICATE
FLOYD SHEPHERD
Date 10 September 1952
Cert: 19868
Place of Death: County: Perry City or Town:
Hazard
Length of stay in hospital or community: 12 days
Name of Hospital or Institution: Mt. Mary Hospital
Usual Residence of Deceased: State: Ky. County: Knott
City or Town: Emmalena
Full Name: Floyd Shepherd
Date of Death: 10 September 1952
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 26 April 1898
Age: 54 years
Usual Occupation: Sawyer [sic]
Kind of Industry or business: Log woods
Birthplace: Ky.
Father's Name: W. M. SHEPHERD
Mother's Maiden Name: Martha Jane RITCHIE
Was deceased ever in armed forces: No
Social Security No.: none
Informant: Willie WALTERS
Disease/condition directly leading to death: Pulmonary
Embolus
Interval between onset and death: Instant
Due to: Crushed Lt. chest, pelvis, lt. kidney injury
Interval between onset and death: 13 days
Date of Operation: (blank)
Major findings of operation: (blank)
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: Hazard, Perry, Ky.
Time of Injury: 28 August 1952 10 a.m.
Injury occurred at work: (blank)
How did injury occur: Log rolled over body
I hereby certify that I attended deceased from 29 August 1952 to
10 September 1952, that I
last saw the deceased alive on 10 September 1952, and that death occurred on
the date stated above at (blank), from the causes and on the date
stated above.
Date signed: 12 Septembr 1952
Address: Hazard, Ky.
Signature: Martin Palmer, M.D.
Burial, Cremation or Removal: Burial
Date: 13 September 1952
Name of Cemetery or Creamatory: Ritchie Cemetery
Location: Ritchie, Ky.
Date received by local registrar: 16 September 1952
Registrar's Signature: George P. Surer
Funeral director and address: Maggard & Garrett, Hazard,
Ky.
Transcribed by Debbie Tamborski, 20 February 2010 |
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