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DEATH
CERTIFICATE
ATTIE VANCE
Date 23 July 1945
Cert: 15748
Place of Death: County: Perry Co. City or
Town: Hazard
Name of Hospital or Institution: Hazard Hosp.
Length of stay in hospital or community:
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: May, Ky.
Full Name: Attie VANCE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: G. W. VANCE
Age of husband or wife if alive: 57
Birth date of deceased: 29 November 1891
Age: 54 years, 08 months, 25 days
Birthplace: Knott Co.
Occupation: House Wife
Industry or business: (blank)
Father Name: W. S. AMBRGY
Father Birthplace: Knott Co.
Mother Maiden Name: Nerva PRATT
Mother Birthplace: Knott Co.
Informant: G. W. VANCE, May, Ky.
Burial Place: May, Ky., Knott Co.
Date: 24 July 1945
Signature funeral director: Maggard Funeral Home, Hazard, Ky.
Date received by local registrar: 01 August 1945
Registrar's Signature: Opsie J. Deaton
Date of Death: 23 July 1945
I hereby certify that I attended deceased from 21 July 1945 to
23 July 1945, that I
last saw him alive on 23 July 1945, and that death occurred on the date
stated above at 4 p.m.
Immediate cause of death: acute bacillary dysentery
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, Hazard, Ky.
Date signed: 30 July 1945
Transcribed by Debbie Tamborski, 09 February 2010 |
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