DEATH
CERTIFICATE
WILLIAM B. SHEPHERD
Date 10 November 1946
Cert: 27342
Place of Death: County: Perry City or
Town: Hazard, Ky.
Name of Hospital or Institution: Hazard Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Tina
Full Name: William B. SHEPHERD
If Veteran Name War: World War I
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Rinda SHEPHERD
Age of husband or wife if alive: (blank)
Birth date of deceased: 13 July 1896
Age: 50 years, 03 months, 27 days
Birthplace: Vest, Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: David SHEPHERD
Father Birthplace: Vest, Ky.
Mother Maiden Name: Orma RICHIE
Mother Birthplace: Vest, 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: 04 December 1946
Registrar's Signature: Opsie Deaton by
Helen Burris, Deputy Registrar
Date of Death: 10 November 1946
I hereby certify that I attended deceased from 09 November
1946 to
10 November 1946, that I
last saw him alive on 10 November 1946, and that death occurred on the date
stated above at 4:30 a.m.
Immediate cause of death: Uremia & shock
Due to: 2 degree & 3 degree (illegible) burns 1/2 to 1/3
(illegible) Face, chest arms
Major findings of operations: (blank)
Accident, suicide, or homicide: accident
Date of occurrence: 09 November 1:30 a.m.
Where did injury occur: House
While at work: no
Means of injury: House burned
Signature: J. M. Ray, M.D., Hazard, Ky.
Date signed: 04 December 1946
Transcribed by Debbie Tamborski, 10 February 2010 |
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