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DEATH
CERTIFICATE
JOHNNY TERRY
Date 21 August 1951
Cert: 21231
Place of Death: County: Perry City or Town:
Hazard
Length of stay in hospital or community:
Name of Hospital or Institution: Mt. Mary Hosp.
Usual Residence of Deceased: State: Ky. County: Knott
City or Town: Rural
Location: Vest, Ky.
Full Name: Johnny TERRY
Date of Death: 21 August 1951
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 15 January 1910
Age: 41 years
Usual Occupation: Labor
Kind of Industry or business: Common Labor
Birthplace: Knott Co., Ky.
Father's Name: Silas TERRY
Mother's Maiden Name: Elizabeth COBURN
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Woots TERRY
Disease or condition directly leading to death:
Peritonitis
Interval between onset and death: (blank)
Due to: Gun shot wound of abdomen, chest & arms
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings for operation: (blank)
Accident, suicide, or homicide: accident
Place of injury: (blank)
City or Town, County, State: Perry, Ky.
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 17 August 1951 to
21 August 1951, that I
last saw the deceased alive on 21 August 1951, and that death occurred on
the date stated above at 4:40 a.m., from the causes and on the date
stated above.
Date signed: 17 October 1951
Address: Hazard, Ky.
Signature: J. E. Hagan, M.D.
Burial, Cremation or Removal: Burial
Date: 23 August 1951
Name of Cemetery or Creamatory: Family Cem.
Location: Knott Co., Ky.
Date received by local registrar: 22 October 1951
Registrar's Signature: Georgia P. Surer
Funeral director and address: Hindman Funeral Home
Transcribed by Debbie Tamborski, 18 February 2010 |
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