Date: 06 April 1941
Cert: 13043
Place of Death: County: Knott Co. 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: Garner
Full Name: Spencer SHORT
If Veteran Name War: (blank)
Social Security No.: 404-06-1320
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Halie Ann SHORT
Age of husband or wife if alive: 51 years
Birth date of deceased: 27 February 1892
Age: 49 years
Birthplace: Knott Co., Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Wilson SHORT
Father Birthplace: Kentucky
Mother Maiden Name: Nancy SLONE
Mother Birthplace: Ky.
Informant: Halie Ann SHORT
Burial Place: Garner
Date: 08 April 1941
Signature of funeral director: (blank)
Date received by local registrar: 05 May 1941
Registrar's Signature: Macie Miller
Date of Death: 06 April 1941
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 (blank)
Immediate cause of death: Pneumonia
Duration: (blank)
Due to: Hodgkin's Disease
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, M.D.
Date signed: (blank)
Transcribed by Debbie Tamborski, 15 October 2010 |