Date: 02 April 1947
Cert: 09220
Place of Death: County: Knott City or
Town: Pippapass, Ky. Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Pippapass Rural
Full Name: Nona SHORT
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Single
Husband or Wife of: none
Age of husband or wife if alive: (blank)
Birth date of deceased: 16 July 1944
Age: 02 years, 08 months, 16 days
Birthplace: Pippapass
Occupation: None - child
Industry or business: (blank)
Father Name: (Pearl SHORT)
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Lula RICHARDSON
Mother Birthplace: Knott Co., Ky.
Informant: Homer HAYWOOD, Hindman, Ky.
Burial Place: Pippapass, Ky.
Date: April 1947
Signature of funeral director: Friends, Pippapass
Date received by local registrar: 21 April 1947
Registrar's Signature: Rose B. Craft
Date of Death: 02 April 1947
I hereby certify that I attended deceased from 01 April 1947 to
02 April 1947, that I last saw her alive on 01 April 1947, and
that death occurred on the date stated above at 8 p.m.
Immediate cause of death: Scarlet fever
Duration: (blank)
Due to: (blank)
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 & Address: M. F. Kelley, M.D., Hindman,
Ky.
Date signed: 08 April 1947
Transcribed by Debbie Tamborski, 20 December 2010 |