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DEATH
CERTIFICATE
DAN SLONE
Date 05 September 1930
Cert: 21934
Place of Death: Voting Pct: Lackey, Floyd Co., Ky.
Full Name: Dan SLONE
Residence: (blank)
Length of Residence in city where death occurred:
(blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Husband Cuba SLONE
Date of Birth: 17 February 1896
Age: 34 years
Occupation: Farming
Birthplace: Knott Co., Ky.
Father Name: J. D. SLONE
Birthplace Father: Ky.
Mother Maiden Name: Anna STURGILL
Birthplace Mother: Ky.
Informant/Address: Cuba SLONE, Pippapass, Ky.
Filed: 02 October 1930
Registrar: G. S. Howard
Death of Date: 05 September 1930
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw h-- alive on (blank), and that death
occurred on the date stated above at (blank)
Cause of Death: Sugar Diabetes
Duration: 01 years
Contributory: (blank)
Duration: (blank)
Where was disease contracted if not at place of death?:
(blank)
Did an operation precede death: (blank) Date: (blank)
Was there an autopsy: (blank)
What test confirmed diagnosis: (blank)
Signed/Address: M. M. Collins, M.D., 02 October 1930
Place of Burial or Removal: Pippapass, Ky.
Date of Burial: 07 September 1930
Undertaker/Address: Mils Jacobs, Pippapass, Ky.
Transcribed by Debbie Tamborski, 29 March 2010 |
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