Date: 14 April 1955
Cert: #7811
Place of Death: County: Knott City or Town:
Lackey - Rural
Length of stay (in this place): (blank)
Name of Hospital or Institution: Stumbo Memorial
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Garner - Rural Street Address: (blank)
Full Name: Marlene THOMAS
Date of Death: 14 April 1955
Sex, Color/Race, Marital Status: Female, White, Never Married
Date of Birth: 30 September 1954
Age: 06 months, 14 days
Usual Occupation: (blank)
Kind of Industry or business: none
Birthplace: Ivis, Ky.
Father's Name: Billy THOMAS
Mother's Maiden Name: Mable SLONE
Was deceased ever in armed forces: None
Social Security No.: (blank)
Informant: Billy THOMAS
Disease or condition directly leading to death: Metabolic
acidosis
Due to: Infantile diarrhea
Interval between onset and death: 02 days
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw the deceased alive on (blank), and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: (blank)
Address: Lackey, Ky.
Signature: Charles L. Roach, M.D.
Burial, Cremation or Removal: Burial
Date: 16 April 1955
Name of Cemetery or Crematory: Perry Slone
Location: Garner, Ky.
Date received by local registrar: 27 April 1955
Registrar's Signature: Myrtle Slone
Funeral director & address: John Everage, Hindman
Transcribed by Debbie Tamborski, 14 May 2011 |