Date: 07 February 1945
Cert: 03964
Place of Death: County: Knott City or
Town: Litt Carr
Street Number or Location: Rural
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Litt Carr Street
No.: Rural
Full Name: Ewens TOLIVER
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White,
Married
Husband or Wife of: Audie SHORT
Age of husband or wife if alive: 42 years
Birth date of deceased: (blank)
Age: 46 years
Birthplace: Knott Co., Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Link TOLIVER
Father Birthplace: Letcher Co., Ky.
Mother Maiden Name: Rebecca COOK
Mother Birthplace: Letcher Co.
Informant: Polina TOLIVER
Burial Place: Toliver Cemetery, Litt Carr
Date: (illegible) February 1945
Signature of funeral director: Tom Toliver, Litt Carr
Date received by local registrar: 10 February 1945
Registrar's Signature: Ida Livingston Rose B. Craft
Acting L. R.
Date of Death: 07 February 1945
I hereby certify that I attended deceased from (blank) to
03 February 1945, that I last saw him alive on 03 February
1945, and that death occurred on the date stated above at 4
a.m.
Immediate cause of death: Cancer of stomache
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: M. F. Kelley, M.D., Hindman,
Ky.
Date signed: 09 February 1945
Transcribed by Debbie Tamborski, 01 December 2010 |