|
DEATH
CERTIFICATE
VIVIAN THORNSBERRY
Date: 28 December 1948
Cert: 27644
Place of Death: County: Floyd
City or Town: Wheelwright
Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Floyd
City or Town: Kite, Ky.
Full Name: Vivian THORNSBERRY
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: 15 September 1948
Age: 03 months, 13 days
Birthplace: Kite, Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: George THORNSBERRY
Father Birthplace: Kite, Ky.
Mother Maiden Name: Roberta BROCK
Mother Birthplace: Jellico, Tenn.
Informant: George THORNSBERRY, Wheelwright,
Ky.
Burial Place: Kite, Ky.
Date: 29 December 1948
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: 01 March
1949
Registrar's Signature: Lucy Ransdell
Date of Death: 28 December 1948
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at 4 a.m.
Immediate cause of death: Spinal meningitis
Duration: (blank)
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 & Address: W. D. Osborne, M.D., Bypro, Ky.
Date signed: 28 February 1949
Transcribed by Debbie Tamborski, 02 July 2010 |
|