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DEATH
CERTIFICATE
WILSON TERRY
Date 22 August 1934
Cert: 19473
Place of Death: Voting Pct.: Frankfort, Franklin Co.,
Ky.
Full Name: Wilson TERRY #20748
Residence: Ky. State Reformatory
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: (illegible)
Date of Birth: 08 October 1898
Age: 35 years, 11 months, 12 days
Occupation: Laborer
Birthplace: Knott County, Kentucky
Father Name: Deceased
Birthplace Father: Don't Know
Mother Maiden Name: Deceased
Birthplace Mother: Don't Know
Informant/Address: Mr. C. K. Megibben, - Chief Clerk,
Kentucky State Reformatory
Burial Cremation Removal Place: Removal - Hindman, Ky.
Date: 23 August 1934
Undertaker/Address: Ranta Funeral Home, Frankfort, Ky.
Filed: 22 August 1934
Registrar: Pauline (illegible), Deputy
Death of Date: 22 August 1934
I hereby certify, That I attended deceased from (illegible) to
(illegible), that I last saw h-- alive on (illegible), death is said
to have occurred on the date stated above, at (illegible)
Cause of Death: Empyema
Date of onset: (blank)
Contributory causes: (blank)
Name of operation: Resection of rib
Date of: 15 August 1934
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: (blank)
Signed/Address: L. D. Adams, M.D., Frankfort, Ky.
Transcribed by Debbie Tamborski, 16 April 2010 |
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