|
DEATH
CERTIFICATE
ALEX THOMAS
Date 30 December 1940
Cert: 03157
Place of Death: County: Pike City or Town:
Mossy Bottom
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Pike
City or Town: Mossy Bottom Street No.:
#47
Full Name: Alex THOMAS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Catherine BREWER
Age of husband or wife if alive: 63 years
Birth date of deceased: 04 November 1968
Age: 72 years
Birthplace: Knot Co., Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Freelan THOMAS
Father Birthplace: N.C.
Mother Maiden Name: Phebie HUNEYCUTT
Mother Birthplace: Knot Co., Ky.
Informant: Sam (illegible), Betsey Layne, Ky.
Burial Place: Island Creek
Date: 01 January 1941
Signature of funeral director: J. W. Call & Son, Pikeville,
Ky.
Date received by local registrar: 07 January 1941
Registrar's Signature: Zinna Justice
Date of Death: 30 December 1940
I hereby certify that I attended deceased 30 December 1940 to
(blank), that I last saw him alive on 30 December 1940, and
that death occurred on the date stated above at 2:30 p.m.
Immediate cause of death: Cerebral hemmorhage
Duration: 01 day
Due to: Hypertension Duration:
Long time
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: S. B. Casebolt, M.D., Pikeville,
Ky.
Date signed: (illegible) 1941
Transcribed by Debbie Tamborski, 11 May 2010 |
|