Date: 19 May 1940
Cert: 15189
Place of Death: County: Knott City or Town:
Rural
Name of Hospital or Institution: Stumbo Memorial Hospital
Length of stay in hospital or community: 09 days
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Rural
Full Name: Cumine THACKER
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: Isaac THACKER
Age of husband or wife if alive: (blank)
Birth date of deceased: 01 April 1874
Age: 66 years
Birthplace: Knott Co.
Occupation: Housekeeping
Industry or business: (blank)
Father Name: Bill TERRY
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Armenda COMBS
Mother Birthplace: Knott Co.
Informant: Isaac THACKER
Burial Place: Mousie
Date: 20 May 1940
Signature of funeral director: (blank)
Date received by local registrar: 29 June 1940
Registrar's Signature: Macie Miller
Date of Death: 19 May 1940
I hereby certify that I attended deceased from 06 May 1940 to
19 May 1940, that I last saw h-- alive on 19 May 1940, and
that death occurred on the date stated above at 4:00 a.m.
Immediate cause of death: Cardiac
Duration: (blank)
Due to: (illegible)
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: W. L. Stumbo, M.D., Lackey, Ky.
Date signed: 17 June 1940
Transcribed by Debbie Tamborski, 06 October 2010 |