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DEATH
CERTIFICATE
SHELBY STURGILL
Date 17 May 1936
Cert: 20296
Place of Death: Voting Pct.: #30, Hazard Hospital Co.,
Hazard, Perry Co., Ky.
Full Name: Shelby STURGILL
Residence: Hindman, Ky.
Length of Residence: Life
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Date of Birth: (blank)
Age: 15 years
Occupation: Student
Birthplace: Knott County, Ky.
Father Name: R. B. STURGILL
Birthplace Father: Kentucky
Mother Maiden Name: Maria VANCE
Birthplace Mother: Kentucky
Informant/Address: R. B. STURGILL, Hindman, Ky.
Burial Cremation Removal Place: Hindman, Ky.
Date: 17 May 1936
Undertaker/Address: G. W. Nicholson, Hazard, Ky.
Filed: 01 August 1936
Registrar: J. P. Boggs
Death of Date: 17 May 1936
I hereby certify, That I attended deceased from 04 May 1936 to
17 May 1936, that I last saw him alive on 17 May 1936, death
is said to have occurred on the date stated above, at 4:35
a.m.
Cause of Death: Peritonitis
Date of onset: (blank)
Contributory causes: Ruptured appendix
Name of operation: Appendectomy
Date of: 05 May 1936
What test confirmed diagnosis: (blank)
Was there an autopsy: No
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: No
Signed/Address: R. L. Collins, M.D., Hazard, Ky.
Transcribed by Debbie Tamborski, 21 April 2010 |
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