Date: 26 January 1944
Cert: 13014
Place of Death: County: Knott City or Town: Dema, Ky.,
Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Dema Rural
Full Name: Mrs. Mary Jane SLONE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Walter SLONE
Age of husband or wife if alive: 53 years
Birth date of deceased: 18 January 1875
Age: 69 years, 00 months, 08 days
Birthplace: Kite, Ky.
Occupation: Housewife
Industry or business: (blank)
Father Name: John L. HALL
Father Birthplace: Kite, Ky.
Mother Maiden Name: Sarah Ellen HALL
Mother Birthplace: Kite, Ky.
Informant: Ena MILLS, Wayland, Ky.
Burial Place: Dema, Ky.
Date: 28 January 1944
Signature of funeral director: Charlie SLONE, Dema, Ky.
Date received by local registrar: (blank)
Registrar's Signature: (blank)
Date of Death: 26 January 1944
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: (blank)
Duration: (blank)
Due to: apoplexy
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., Hindman
Date signed: 22 March 1945
Transcribed by Debbie Tamborski, 22 November 2010 |