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DEATH
CERTIFICATE
JOPHAS (JOSEPH) SLONE
Date 15 July 1941
Cert: 16969
Place of Death: County: Floyd Co. City or Town:
Wayland
Name of hospital or institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County: Floyd
City or Town: Wayland
Full Name: Jophas SLONE (Joseph)
If Veteran Name War: (blank)
Social Security No.: 400-01-8355
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Marry SLON
Age of husband or wife if alive: 28 years
Birth date of deceased: 14 March 1904
Age: 37 years, 04 months, 01 days
Birthplace: Raven, Ky.
Occupation: Miner
Industry or business: Elkhorn Coal Corp.
Father Name: Ruben SLONE
Father Birthplace: Raven, Ky.
Mother Maiden Name: Elizabeth SHORT
Mother Birthplace: Knott Co.
Informant: (?Malcans?--illegible) SLONE, Wayland, Ky.
Burial Place: Raven, Ky.
Date: 16 July 1941
Signature of funeral director: O. T. Lemaster, Martin, Ky.
Date received by local registrar: 31 July 1941
Registrar's Signature: Mrs. Ben Norris
Date of Death: 15 July 1941
I hereby certify that I attended deceased from 15 July 1941 to
25 July 1941, that I last saw him alive on 15 July 1941, and
that death occurred on the date stated above at 11:00 p.m.
Immediate cause of death: Crushed head
Duration: (blank)
Due to: Slate fall in mines
Major findings of operations: (blank)
Accident, suicide, or homicide: Accident
Date of occurrence: 15 July 1941
Where did injury occur: Industrial place
While at work: yes
Means of injury: Crushed skull
Signature & Address: O. T. Lemaster, F. D., Martin,
Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 14 May 2010 |
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