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DEATH
CERTIFICATE
OTIS SLOAN
Date 11 September 1943
Cert: 21053
Place of Death: County: Perry City or
Town: Vicco
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: 2 hrs
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Garner (Rural)
Full Name: Otis SLOAN
If Veteran Name War: No
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Florida SPARKMAN SLOAN
Age of husband or wife if alive: 25 years
Birth date of deceased: 15 July 1915
Age: 28 years, 01 months, 26 days
Birthplace: Garner, Kentucky
Occupation: Bulldozer Operator
Industry or business: Coal Mining
Father Name: Willie SLOAN
Father Birthplace: Raven, Kentucky
Mother Maiden Name: Ida SLOAN
Mother Birthplace: Garner, Kentucky
Informant: Ben SLOAN, Garner, Kentucky
Burial Place: Garner, Kentucky
Date: 13 September 1943
Signature funeral director: Maggard Funeral Home, Hazard, Ky.
Date received by local registrar: 11 October 1943
Registrar's Signature: Anna L. Boulos
Date of Death: 11 September 1943
I hereby certify that I attended deceased from (blank) to
(blank), that I
last saw him alive on 11 September 1943, and that death occurred on the date
stated above at about 5 p.m.
Immediate cause of death: Gun Shot Wound in lower region
of left lung. Hemorrhage
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: Homicide
Date of occurrence: 11 September 1943
Where did injury occur: Public Bus Station
While at work: (blank)
Means of injury: (blank)
Signature: Ed H. (illegible), Coroner,
Perry County, Allias, Kentucky
Date signed: 12 September 1943
Transcribed by Debbie Tamborski, 06 February 2010 |
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