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DEATH
CERTIFICATE
NARVA DEAN SKILES
Date: 01 November 1940
Cert: 29246
Place of Death: Voting Pct.: Lackey, Knott Co., Ky.
Name of Hospital or Institution: Stumbo
Full Name: Narva Dean SKILES
Residence: Weeksbury
Length of Residence: (blank)
Sex, Color or Race, Marital Status Male, White, Single
Husband or Wife of: (blank)
Date of Birth: 17 January 1937
Age: 03 years, 09 months, 15 days
Occupation: (blank)
Birthplace: Ky.
Father Name: Johnny SKILES
Birthplace Father: Tenn.
Mother Maiden Name: Sadie SWORD
Birthplace Mother: Ky.
Informant/Address: Johnny SKILES, Weeksbury, Ky.
Burial Cremation Removal Place: Weeksbury, Ky.
Date: 03 November 1940
Undertaker/Address: F. H. Malone, Bypro, Ky.
Filed: 29 December 1940
Registrar: Macie Miller
Death of Date: 01 November 1940
I hereby certify, That I attended deceased from 31 October
1940 to 01 November 1940, that I last saw him alive on
(blank), death is said to have occurred on the date stated
above, at 11 a.m.
Cause of Death: (blank)
Date of onset: (blank)
Contributory causes: (blank)
Name of operation: (blank)
Accident, suicide, homicide: Accident
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home,
public place: At play
Manner of injury: Head injury
Nature of injury: Traumatic meningitis
Related to occupation: No
Signed/Address: W. L. Stumbo, M.D., 07 November 1940
Transcribed by Debbie Tamborski, 28 August 2010 |
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