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DEATH
CERTIFICATE
CHARLEEN SUMNER
Date 21 June 1944
Cert: 13524
Place of Death: County: Perry City or
Town: Hazard
Name of Hospital or Institution: Hazard Hosp.
Length of stay in hospital or community:
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Anoc
Full Name: Charleen SUMNER
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, (blank)
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: (blank)
Age: 02 days
Birthplace: Hazard, Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: Lanzy SUMNER
Father Birthplace: (blank)
Mother Maiden Name: Mary Lee SUMNER
Mother Birthplace: (blank)
Informant: (blank)
Burial Place: (blank)
Date: (blank)
Signature of funeral director: Maggard
Date received by local registrar: 24 May 1945
Registrar's Signature: Opsie J. Deaton
Date of Death: 21 June 1944
I hereby certify that I attended deceased from 20 June 1944 to
21 June 1944, that I
last saw him alive on 21 June 1944, and that death occurred on the date
stated above at 5 a.m.
Immediate cause of death: Prematurity
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: Chris S. Jackson, M.D., Hazard, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 09 February 2010 |
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