Date: 30 September 1943
Cert: 15280
Place of Death: County: Knott City or
Town: Pippapass
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Pippapass
Full Name: Laura SLONE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Widowed
Husband or Wife of: Camillus SLONE
Age of husband or wife if alive: (blank)
Birth date of deceased: 06 January 1901
Age: 42 years, 08 months, 24 days
Birthplace: Garner (Knott Co.) Kentucky
Occupation: Housewife
Industry or business: (blank)
Father Name: Mack SLONE
Father Birthplace: Knott County, Kentucky
Mother Maiden Name: Sarah SLONE
Mother Birthplace: Knott County, Kentucky
Informant: Wessaker SHORT, Pippapass, Kentucky
Burial Place: Pippapass, Ky.
Date: 30 September 1943
Signature of funeral director: Friends, Pippapass, Ky.
Date received by local registrar: (blank)
Registrar's Signature: (blank)
Date of Death: 30 September 1943
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Pulmonary Tuberculosis
Duration: (blank)
Due to: No physician in attendance
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: J. W. Duke, M.D., County Health
Officer, Hindman, Kentucky
Date signed: 13 March 1945
Transcribed by Debbie Tamborski, 27 October 2010 |