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DEATH
CERTIFICATE
GRANVILLE P. STACEY
Date: 12 December 1945
Cert: 25353
Place of Death: County: Fayette City or Town:
Lexington, Kentucky (Rural)
Hospital or Institution: Veterans Administration Center
Length of stay in hospital or community: 30 days
Usual Residence of Deceased: State: Kentucky County:
Laurel
City or Town: London Street No.:
Whitley Street
Full Name: Granville P. STACEY
If Veteran Name War: World War I
Social Security No.: unknown
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Margaret CORNETT
Age of husband or wife if alive: unknown
Birth date of deceased: 07 September 1870
Age: 75 years, 03 months, 05 days
Birthplace: Sassafras, Ky.
Occupation: Teacher and Attorney
Industry or business: (blank)
Father Name: Simeon S. STACEY
Father Birthplace: Kentucky
Mother Maiden Name: Elizabeth COMBS Stacey
Mother Birthplace: Kentucky
Informant: Hospital Records, Veterans
Administration, Lexington, Ky.
Removal Place: London, Ky.
Date: 13 December 1945
Signature of funeral director: House Funeral Home, London, Ky.
Date received by local registrar: 07 January 1946
Registrar's Signature: D. A. Furlong
Date of Death: 12 December 1945
I hereby certify that I attended deceased from 12 November
1945 to
12 December 1945, that I last saw him alive on 12 December
1945, and that death occurred on the date stated above at
12:20 p.m.
Immediate cause of death: Hypertensive heart disease
Duration: 04 months
Due to: General arteriosclerosis
Duration: Indef.
Major findings of operations: No operation - No Autopsy
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: O. P. Miller, Lt. Col., M.C.,
Chief Med. Officer, Vets. Admin., Lex., Ky.
Date signed: 12 December 1945
Transcribed by Debbie Tamborski, 06 June 2010 |
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