Date: 10 April 1953
Cert: 15050
Place of Death: County: Knott
City or Town: Vest, Ky. Rural
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Vest, Ky. If rural give
location:
(blank)
Full Name: Henderson D. SHEPHERD
Date of Death: 10 April 1953
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 02 April 1878
Age: 75 years
Usual Occupation: Retired Teacher
Kind of Industry or business: (blank)
Birthplace: Knott Co.
Father's Name: John Riley SHEPHERD
Mother's Maiden Name: Irene SMITH
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Leanner SHEPHERD
Disease or condition directly leading to death: Hypertensive &
arteriosclerotic heart disease
Interval between onset and death: 06 years
Due to (b): Hypertension
Interval between onset and death: unknown
Due to (c): arteriosclerosis
Other significant conditions: chronic nephritis
Interval between onset and death: 05 years
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (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 15 March 1948
to 15 March 1953, that I last saw the deceased alive on 15
March 1953, and that death occurred at 5:45 p.m., from the
causes and on the date stated above.
Date signed: 13 April 1953
Address: Hindman, Ky.
Signature: D. G. Barker, M.D.
Burial, Cremation or Removal: Burial
Date: 11 April 1953
Name of Cemetery or Crematory: Holliday Cemetery
Location: Ary, Ky.
Date received by local registrar: 31 July 1953
Registrar's Signature: Rose B. Craft
Funeral director & address: John Everage, Hindman, Ky.
Transcribed by Debbie Tamborski, 11 February 2011 |