Date: 29 May 1955
Cert: #12150
Place of Death: County: Knott City or Town:
Lackey - Rural
Length of stay (in this place): 01
Name of Hospital or Institution: Stumbo Memorial
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Garner - Rural Street Address: (blank)
Full Name: Andrew SLONE
Date of Death: 29 May 1955
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 30 March 1892
Age: 63 years
Usual Occupation: Farmer
Kind of Industry or business: (blank)
Birthplace: Knott Co., Ky.
Father's Name: Reese SLONE
Mother's Maiden Name: Nancy JOHNSON
Was deceased ever in armed forces: Yes
Social Security No.: (blank)
Informant: Evelyn SLONE
Disease/condition directly leading to death: Cerebral
hemorrhage
Interval between onset and death: 19 hours
Due to: Hypertensive cardiovascular disease
Interval between onset and death: Unknown
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 29 May 1955 to
29 May 1955, that I last saw the deceased alive on 29 May
1955, and that death occurred at 8:30 p.m., from the causes
and on the date stated above.
Date signed: 06 June 1955
Address: Lackey, Ky.
Signature: Charles L. Roach, M.D.
Burial, Cremation or Removal: Burial
Date: 31 May 1955
Name of Cemetery or Crematory: Slone
Location: Pippapass, Ky.
Date received by local registrar: 24 June 1955
Registrar's Signature: Myrtle Slone
Funeral director & address: John Everage, Hindman, Ky.
Transcribed by Debbie Tamborski, 14 May 2011 |