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DEATH
CERTIFICATE
JANICE STURDIVANT SHORT
Date 12 April 1945
Cert: 08380
Place of Death: County: Jefferson City or
Town: Rural (Louisville crossed through)
Name of Hospital or Institution: Nichols General
Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Hindman
Full Name: Janice STURDIVANT SHORT
If Veteran Name War: World War II
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Elmon SHORT
Age of husband or wife if alive: unknown
Birth date of deceased: 22 January 1923
Age: 22 years, 02 months, 21 days
Birthplace: Hardburly, Kentucky
Occupation: Prior: Waitress
Pres: Soldier
Industry or business: Prior: Unknown
Pres: U.S. Army
Father Name: Unknown
Father Birthplace: Unknown
Mother Maiden Name: Unknown
Mother Birthplace: Unknown
Informant: Official Records, U.S. Army
Removal: Engle Funeral Home, Hazard, Ky.
Date: 13 April 1945
Signature of funeral director: Bohlsen Funeral Home, 825
Barret Ave., Louisville, Ky.
Date received by local registrar: 15 April 1945
Registrar's Signature: N. N. (illegible)
Date of Death: 12 April 1945
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 9:35 p.m.
Immediate cause of death: poisoning, severe, due to
cyanide taken with suicidal intent at Nichols General
Hospital, Louisville 2, Kentucky
Due to: (blank)
Major findings of autopsy: Same as above
Accident, suicide, or homicide: Suicide
Date of occurrence: 12 April 1945
Where did injury occur: AC Barracks, Nichols Gen. Hosp.,
Louisville 2, Ky.
While at work: No
Means of injury: Poison
Signature: Dr. Vincent Stabile, Coroner by Chas K.
(illegible), Fiscal Court Building
Date signed: 17 April 1945
Transcribed by Debbie Tamborski, 09 February 2010 |
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