Date: 21 June 1944
Cert: 18744
Place of Death: County: Knott City or Town: Lackey, 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: Lackey, Ky. Rural
Full Name: Ray STANLEY
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: 25 December 1943
Age: 05 months, 26 days
Birthplace: Lackey, Ky. Rural
Occupation: None
Industry or business: (blank)
Father Name: Henry Gorden STANLEY
Father Birthplace: Wise Co., Va.
Mother Maiden Name: Marie BROWN
Mother Birthplace: Lackey, Knott Co., Ky.
Informant: Gorden STANLEY, Lackey, Ky.
Burial Place: Porter Cemetery
Date: 22 June 1944
Signature of funeral director: Frank Moore, Lackey, Ky.
Date received by local registrar: 28 August 1944
Registrar's Signature: Ida Livingston
Date of Death: 21 June 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: Pneumonia
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: Mark Dempsey, M.D., Garrett, Ky.
Date signed: 20 August 1944
Transcribed by Debbie Tamborski, 24 November 2010 |