|
DEATH
CERTIFICATE
HILLARD SLONE
Date 19 January 1931
Cert: 16623
Place of Death: Voting Pct: Wayland, Martin, Floyd Co.,
Ky.
Full Name: Hillard SLONE
Residence: Dema, Ky.
Length of Residence in city where death occurred:
(blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Date of Birth: 06 April 1908
Age: 23 years, 09 months, 13 days
Occupation: Farming
Birthplace: Raven, Ky.
Father Name: Reuben SLONE
Birthplace Father: Raven, Ky.
Mother Maiden Name: Elizabeth SHORT
Birthplace Mother: Raven, Ky.
Informant/Address: Mrs. Bert NICKLES, Raven, Ky.
Sherman SLONE, Wayland, Ky.
Filed: 03 August 1931
Registrar: Mrs. M. V. Wicker per B. Carns
Death of Date: 19 January 1931
I hereby certify that I attended deceased from 18 January 1931 to
19 January 1931, that I last saw him alive on 19 January 1931,
and that death occurred on the date stated above at 7 p.m.
Cause of Death: Homicide - gun shot wound
Duration: 01 day
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. V. Wicker, M.D., 19
January 1931, Wayland, Ky.
Place of Burial or Removal: Slone Cemetery
Date of Burial: 19 January 1931
Undertaker/Address: Family, Wayland, Ky.
Transcribed by Debbie Tamborski, 31 March 2010 |
|