Date: 24 November 1942
Cert: 27287
Place of Death: County: Knott City or
Town: Lackey
Name of Hospital or Institution: Stumbo Mem. Hosp.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Floyd
City or Town: Lambert, Ky.
Full Name: Jerold Breckinridge SLOAN
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 19 August 1938
Age: 04 years, 03 months, 10 days
Birthplace: Fed, Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Wade SLOAN
Father Birthplace: Floyd Co., Ky.
Mother Maiden Name: Tina May MEADE
Mother Birthplace: Floyd Co., Ky.
Informant: Earl MEADE, Fed, Ky.
Burial Place: Fed, Ky.
Date: 29 November 1942
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: 02 December 1942
Registrar's Signature: Ida Livingston
Date of Death: 29 November 1942
I hereby certify that I attended deceased from 12 November
1942 to
29 November 1942, that I last saw him alive on 29 November
1942, and that death occurred on the date stated above at 2:30
p.m.
Immediate cause of death: Pneumococcic Meningitis
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: Edward R. Codden, M.D., Martin
Date signed: 01 December 1942
Transcribed by Debbie Tamborski, 18 October 2010 |