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DEATH
CERTIFICATE
MANUEL SLONE
Date 02 December 1941
Cert: 28492
Place of Death: County: Floyd City or Town:
Martin
Name of Hospital or Institution: Beaver Valley Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County: Johnson
City or Town: Paintsville Street No:
Depot Road
Full Name: Manuel SLONE
If Veteran Name War: (blank)
Social Security No.: 234-05-7438
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Mary JACOBS
Age of husband or wife if alive: 46 years
Birth date of deceased: 27 April 1885
Age: 55 years, 07 months, 05 days
Birthplace: Knott Co., Ky.
Occupation: Salesman for Wilson & Co.
Industry or business: Meat Products
Father Name: Henry SLONE
Father Birthplace: Ky.
Mother Maiden Name: Sally SLONE
Mother Birthplace: Ky.
Informant: Mrs. Mary SLONE, Paintsville, Ky.
Burial Place: Paintsville, Ky.
Date: 05 December 1941
Signature of funeral director: Paintsville
Furniture Co., Paintsville, Ky.
Date received by local registrar: 08 December 1941
Registrar's Signature: Mrs. Ben Norris
Date of Death: 02 December 1941
I hereby certify that I attended deceased from 01 December
1941 to
02 December 1941, that I last saw him alive on 02 December
1941, and that death occurred on the date stated above at 3:00
p.m.
Immediate cause of death: 1-Concussion of Brain 2-Compound
Fracture of Mandible 3-Fractured Pelvis
Duration: (blank)
Due to: Automobile Accident
Major findings of operations: (blank)
Accident, suicide, or homicide: Accident
Date of occurrence: 01 December 1941
Where did injury occur: Public Highway #80
While at work: yes
Means of injury: Auto Wreck
Signature & Address: Edward R. Codden, M.D., Martin,
Ky.
Date signed: 02 December 1941
Transcribed by Debbie Tamborski, 14 May 2010 |
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