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DEATH
CERTIFICATE
KELLY C. SNOW
Date 04 October 1952
Cert: 20270
Place of Death: County: Boyd City or Town:
Rural
Length of stay in hospital or community: 13 mo.
Name of Hospital/Institution: Distr. 4 T.B. Hosp.,
Ashland, Ky.
Usual Residence of Deceased: State: Kentucky County: Knott
City or Town: Sassafras
Full Name: Kelly C. SNOW
Date of Death: 04 October 1952
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 03 August 1904
Age: 48 years
Usual Occupation: Truck Driver
Kind of Industry or business: Constr. Co.
Birthplace: Virginia
Father's Name: Fate SNOW
Mother's Maiden Name: Ethel THOMAS
Was deceased ever in armed forces: No
Social Security No.: 400-10-8906
Informant: Hospital Record
Disease or condition directly leading to death:
Pulmonary Tuberculosis
Interval between onset and death: Approx. 31 mo.
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 05 September
1951 to
04 October 1952, that I
last saw the deceased alive on 03 October 1952, and that death occurred on
the date stated above at 3:35 a.m., from the causes and on the date
stated above.
Date signed: 04 October 1952
Address: Distr. 4 T.B. Hospital, Ashland, Ky.
Signature: W. Duane Jones, M.D., Distr. 4 T.B. Hospital
Burial, Cremation or Removal: Removal and Burial
Date: not known
Name of Cemetery or Creamatory: Harlan Cem.
Location: Near Harlan, Ky.
Date received by local registrar: 16 October 1952
Registrar's Signature: Mrs. C. P. Garten
Funeral director and address: Lazear Funeral Home,
Ashland, Ky. by Paul Lazear
Transcribed by Debbie Tamborski, 20 February 2010 |
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