|
DEATH
CERTIFICATE
LOVELLIE TERRY
Date 06 October 1949
Cert: 23886
Place of Death: County: Perry City or Town:
Bulan
Length of stay in hospital or community: (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky. County: Knott
City or Town: Tiny
Full Name: Lovellie TERRY
Date of Death: 06 October 1949
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 09 June 1911
Age: 38 years
Usual Occupation: Housewife
Kind of Industry or business: (blank)
Birthplace: Kentucky
Father's Name: Raynold HICKS
Mother's Maiden Name: Rhoda HUGUES
Was deceased in ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Barm TERRY
Disease or condition directly leading to death: (blank)
Interval between onset and death: (blank)
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings for operation: (blank)
Accident, suicide, or homicide: Accident
Place of injury: Public Highway
City or Town, County, State: Bulan, Perry, Ky.
Time of Injury: 06 October 1949 1:30 p.m.
Injury occurred at work: (blank)
How did injury occur: Car Wreck
I hereby certify that I attended deceased from (blank) to
(blank), that I
last saw the deceased alive on (blank), and that death occurred on
the date stated above at (blank), from the causes and on the date
stated above.
Date signed: 24 October 1949
Address: (blank)
Signature: Ed H. (illegible), Coroner, Perry Co.
Burial, Cremation or Removal: Burial
Date: 09 October 1949
Name of Cemetery or Creamatory: Montgomery Cr. Cem.
Location: Knott, Ky.
Date received by local registrar: 03 December 1949
Registrar's Signature: Georgia Pendleton
Funeral director/address: Johnson Funeral Home, Hazard,
Ky.
Transcribed by Debbie Tamborski, 16 February 2010 |
|