Date: 03 August 1953
Cert: 17004
Place of Death: County: Knott
City or Town: Rural
Length of stay (in this place): (blank)
Street address or location: Elmrock, Ky.
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural If rural give
location: Elmrock, Ky.
Full Name: Clyde TERRY
Date of Death: 03 August 1953
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 09 March 1929
Age: 24 years
Usual Occupation: Farmer
Kind of Industry or business: Farming
Birthplace: Knott Co., Ky.
Father's Name: Elijah TERRY
Mother's Maiden Name: Verda THOMAS
Was deceased ever in armed forces: No
Social Security No.: (blank)
Informant: Mrs. Elijalh TERRY
Disease or condition directly leading to death: loss of blood
from stab wounds
Interval between onset and death: (blank)
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw the deceased alive on (blank), and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: 03 August 1953
Address: Hindman, Ky.
Signature: Jno. N. Taul, Coroner
Burial, Cremation or Removal: Burial
Date: 06 August 1953
Name of Cemetery or Crematory: Family Cemetery
Location: Elmrock, Ky.
Date received by local registrar: 12 August 1953
Registrar's Signature: Mrs. Rose B. Craft
Funeral director & address: John N. Taul, Hindman,
Ky.
Transcribed by Debbie Tamborski, 12 February 2011 |