Date: 13 December 1940
Cert: 29240
Place of Death: County: Knott City or Town:
Carrie
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: Carrie
Full Name: Euarrie SPARKMAN
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 20 May 1862
Age: 78 years
Birthplace: Hollybush, Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Argie SPARKMAN
Father Birthplace: Knott Co.
Mother Maiden Name: Sally REYNOLDS
Mother Birthplace: Knott Co.
Informant: Ibby SHORT, Carrie, Ky.
Burial Place: Pippapass
Date: 15 December 1940
Signature of funeral director: Family, Pippapass
Date received by local registrar: 16 December 1940
Registrar's Signature: Macie Miller
Date of Death: 13 December 1940
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: Senility
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.
Date signed: (blank)
Transcribed by Debbie Tamborski, 06 October 2010 |