Date: 02 January 1944
Cert: 09960
Place of Death: County: Knott City or
Town: Pippapass, Ky.
Street Number or Location: Rural
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Pippapass, Ky.
Street No.: Rural
Full Name: Adam SLONE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Widowed
Husband or Wife of: Christiana REYNOLDS
Age of husband or wife if alive: deceased
Birth date of deceased: 27 August 1862
Age: 81 years, 04 months, 05 days
Birthplace: Floyd County
Occupation: Farming
Industry or business: Farming
Father Name: Adam SLONE
Father Birthplace: Floyd County
Mother Maiden Name: Christiana REYNOLDS
Mother Birthplace: Letcher County
Informant: Bertha HALL, Hollybush, Ky.
Burial Place: Hollybush, Ky.
Date: 04 January 1944
Signature of funeral director: Marion Slone, Pippapass
Date received by local registrar: 29 April 1944
Registrar's Signature: Ida Livingston
Date of Death: 02 January 1944
I hereby certify that I attended deceased from 01 January 1944 to
03 January 1944, that I last saw him alive on 02 January 1944,
and that death occurred on the date stated above at 9 p.m.
Immediate cause of death: (blank)
Duration: (blank)
Due to: Apoplexy
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: M. F. Kelley, M.D., Hindman,
Ky.
Date signed: 29 April 1944
Transcribed by Debbie Tamborski, 22 November 2010 |