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DEATH
CERTIFICATE
ROBERT S. SHORT
Date: 19 May 1940
Cert: 15186
Place of Death: County: Knott City or Town:
Garner
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Garnet
Full Name: Robert S. SHORT
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Linda SHORT
Age of husband or wife if alive: 34 years
Birth date of deceased: 15 March 1857
Age: 83 years
Birthplace: Virginia - Wise Co.
Occupation: Practiced medicine
Industry or business: (blank)
Father Name: James SHORT
Father Birthplace: Virginia
Mother Maiden Name: (blank)
Mother Birthplace: (blank)
Informant/Address: Linda SHORT, Garner
Burial Place: Garner
Date: 20 May 1940
Signature of funeral director/address: (blank)
Date received by local registrar: 06 June 1940
Registrar's Signature: Macie Miller
Date of Death: 19 May 1940
I hereby certify that I attended deceased from January 1940 to
19 May 1940, that I last saw him alive on 19 May 1940, and
that death occurred on the date stated above at 5:30 p.m.
Immediate cause of death: Pneumonia
Duration: (blank)
Due to: Pulmonary Tuberculosis
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: J. W. Duke, Hindman
Date signed: 06 June 1940
Transcribed by Debbie Tamborski, 28 August 2010 |
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