Date: 03 November 1944
Cert: 13009
Place of Death: County: Knott City or
Town: Lackey
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Lackey
Full Name: Fred UNDERWOOD
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Belle UNDERWOOD
Age of husband or wife if alive: (blank)
Birth date of deceased: 25 December 1881
Age: 63 years, 11 months, 08 days
Birthplace: Wellston, Ohio
Occupation: Auto Mechanic
Industry or business: Lackey Motors
Father Name: John UNDERWOOD
Father Birthplace: Ohio
Mother Maiden Name: Margaret EXLINE
Mother Birthplace: Don't know
Informant: Mrs. Belle UNDERWOOD, Lackey, Ky.
Burial Place: Auxier, Ky.
Date: 05 November 1944
Signature of funeral director: John Jones, Paintsville,
Ky.
Date received by local registrar: 19 March 1945
Registrar's Signature: Rose B. Craft acting Registrar Per
B. Carns
Date of Death: 03 November 1944
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 (blank)
Immediate cause of death:
Duration: (blank)
Due to: High Blood pressure Cerebral Hemorrhage
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: Dr. M. M. Collins, M.D., Lackey,
Ky.
Date signed: 19 March 1945
Transcribed by Debbie Tamborski, 26 November 2010 |