Date: 07 February 1944
Cert: 04915
Place of Death: County: Knott City or
Town: Hindman, Ky.
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: Mrs. Ida SULLIVAN
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Widowed
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 21 January 1865
Age: 79 years, 16 days
Birthplace: Mich.
Occupation: House Keeper
Industry or business: (blank)
Father Name: Marcum BERCHLEY
Father Birthplace: ? (transcribed as written)
Mother Maiden Name: Mary Jane BENTLEY
Mother Birthplace: Mich.
Informant: G. D. FRANKLIN, Hindman, Ky.
Burial Place: Emalena, Ky.
Date: 09 February 1944
Signature of funeral director: Engles, Hazard, Ky.
Date received by local registrar: 29 February 1944
Registrar's Signature: Ida Livingston
Date of Death: 07 February 1944
I hereby certify that I attended deceased from 01 January 1944 to
07 February 1944, that I last saw -- alive on 07 February 1944, and that death
occurred on the date stated above at 3 p.m.
Immediate cause of death: Cancer of the breast
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: M. F. Kelley, M.D., Hindman,
Ky.
Date signed: 21 February 1944
Transcribed by Debbie Tamborski, 24 November 2010 |