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DEATH
CERTIFICATE
JAMES SHEPHERD
Date 05 August 1941
Cert: 19308
Place of Death: County: Fayette City or Town:
Lexington
Name of Hospital or Institution: Eastern State Hospital
Length of stay in hospital or community:
8 years, 7 months, 12 days
Usual Residence of Deceased: State: Kentucky County:
Knott
City or Town: Elmrock
Full Name: James SHEPHERD
If Veteran Name War: (blank)
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: 1904
Age: 37 years
Birthplace: unknown
Occupation: None
Industry or business: (blank)
Father Name: Abe SHEPHERD
Father Birthplace: Elmrock, Ky.
Mother Maiden Name: Lizzie SHEPHERD
Mother Birthplace: unknown
Informant: Eastern State Hospital Records, Lexingtin,
Kentucky
Burial Place: Elmrock, Ky.
Date: 08 August 1941
Signature of funeral director: D. M. Lowe, Lex., Ky.
Date received by local registrar: 12 August 1941
Registrar's Signature: D. A. Furlong
Date of Death: 05 August 1941
I hereby certify that I attended deceased from July 1939 to 05
August 1941, that I
last saw him alive on 05 August 1941, and that death occurred on the date
stated above at 11:20 p.m.
Immediate cause of death: Pulmonary tuberculosis
Due to: Dementia precox paranoid type
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature: G. G. Auxier, M.D., E. State Hosp.,
Lexington, Ky.
Date signed: 06 August 1941
Transcribed by Debbie Tamborski, 01 February 2010 |
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