Date: 23 January 1941
Cert: 02297
Place of Death: County: Knott Co. City or
Town: Hindman
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: Hindman
Full Name: Mary Ann STURGILL
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Widowed
Husband or Wife of: Jack STURGILL
Age of husband or wife if alive: (blank)
Birth date of deceased: 09 September 1863
Age: 77 years
Birthplace: Letcher Co.
Occupation: House work
Industry or business: (blank)
Father Name: James STURGILL
Father Birthplace: Letcher Co.
Mother Maiden Name: Beckey CAUDILL
Mother Birthplace: Letcher Co.
Informant: David STURGILL, Hindman
Burial Place: Hindman, Ky.
Date: 23 January 1941
Signature of funeral director: (blank)
Date received by local registrar: 31 January 1941
Registrar's Signature: Macie Miller
Date of Death: 23 January 1941
I hereby certify that I attended deceased from 20 January 1941 to
23 January 1941, that I last saw her alive on 23 January 1941,
and that death occurred on the date stated above at 8:00 p.m.
Immediate cause of death: influenza
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: J. W. Duke, M.D., Hindman
Date signed: (blank)
Transcribed by Debbie Tamborski, 15 October 2010 |