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DEATH
CERTIFICATE
W. S. TAYLOR
Date: 10 December 1947
Cert: 28166
Place of Death: County: Clark City or Town:
Winchester
Street No. or Location: 127 Jefferson St.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Clark
City or Town: Winchester Street No. or
Location: 127 Jefferson Street
Full Name: W. S. TAYLOR
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: 14 April 1868
Age: 79 years, 08 months, 06 days
Birthplace: Knot Co., Ky.
Occupation: None
Industry or business: (blank)
Father Name: Felix TAYLOR
Father Birthplace: Knot Co.
Mother Maiden Name: Rena THOMAS
Mother Birthplace: Knot Co.
Informant: Dema TAYLOR, Martin, Ky.
Burial Place: Winchester Cemetery
Date: 11 December 1947
Signature of funeral director: D. B. Scobee, Winchester, Ky.
Date received by local registrar: 22 December
1947
Registrar's Signature: Mary M. Douglas
Date of Death: 10 December 1974
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 8:30 a.m.
Immediate cause of death: (blank)
Duration: (blank)
Due to: Arteriosclerotic Heart Disease Hardening of the
arteries
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: Charles (illegible), Deputy
Coroner, Winchester, Ky.
Date signed: 21 December 1947
Transcribed by Debbie Tamborski, 26 June 2010 |
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