Date: 26 December 1944
Cert: 13035
Place of Death: County: Knott City or
Town: Lackey
Name of Hospital or Institution: Stumbo Mem. Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Mousie
Full Name: Nan SLONE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Bee SLONE
Age of husband or wife if alive: (blank)
Birth date of deceased: 24 December 1874
Age: 70 years, 00 months, 02 days
Birthplace: Colson, Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: (blank)
Father Birthplace: (blank)
Mother Maiden Name: Dulsina MULLINS
Mother Birthplace: Colson, Ky.
Informant: Bee SLONE, Mousie, Ky.
Burial Place: Pippapass, Ky.
Date: 28 December 1944
Signature of funeral director: Floyd Caudill, Hollybush,
Ky.
Date received by local registrar: 21 March 1945
Registrar's Signature: Rose B. Craft
Acting Registrar Per B. Carns
Date of Death: 26 December 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: Carcinoma of cervix
Duration: (blank)
Due to: (blank)
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: A. R. Hodge, M.D., Lackey, Ky.
Date signed: 21 March 1945
Transcribed by Debbie Tamborski, 22 November 2010 |