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DEATH
CERTIFICATE
GLORIA THOMAS
Date 27 March 1943
Cert: 07368
Place of Death: County: Perry City or
Town: Hazard, Ky.
Name of Hospital or Institution: Hazard Hospital Co.
Length of stay in hospital or community:
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural
Full Name: Gloria THOMAS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 17 April 1939
Age: 02 years, 11 months, 10 days
Birthplace: Perry Co.
Occupation: (blank)
Industry or business: (blank)
Father Name: William THOMAS
Father Birthplace: Harlan Co.
Mother Maiden Name: Ettie COMBS
Mother Birthplace: Lee Co., Ky.
Informant: William THOMAS, Anco, Ky.
Burial Place: Riverside
Date: 30 March 1943
Signature funeral director: Engle Und. & Hdw. Co., Hazard, Ky.
Date received by local registrar: 05 April 1943
Registrar's Signature: Anna Laura Boulos
Date of Death: 27 March 1943
I hereby certify that I attended deceased from 17 March 1943 to
27 March 1943, that I
last saw him alive on 27 March 1943, and that death occurred on the date
stated above at 5 p.m.
Immediate cause of death: influenza meningitis
Due to: (blank)
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: Chris S. Jackson, M.D., Hazard, Ky.
Date signed: 02 April 1943
Transcribed by Debbie Tamborski, 06 February 2010 |
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