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DEATH
CERTIFICATE
DICK VANCE
Date 05 November 1937
Cert: 28966
Place of Death: Voting Pct.: Colson, Letcher Co., Ky.
Full Name: Dick VANCE
Residence: Polly, Ky.
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Rosa VANCE
Date of Birth: 18 December 1890
Age: 47 years, 10 months, 05 days
Occupation: unemployed
Birthplace: Knott Co., Ky.
Father Name: Austin VANCE
Birthplace Father: Knott Co., Ky.
Mother Maiden Name: Eliza PIGMAN
Birthplace Mother: Knott Co., Ky.
Informant/Address: Shade ADAMS, Polly, Ky.
Burial Cremation Removal Place: Colson
Date: 06 November 1937
Undertaker/Address: Family
Filed: 18 November 1937
Registrar: J. Don Collins
Death of Date: 05 November 1937
I hereby certify, That I attended deceased from (blank) to
(blank), that I last saw h-- alive on (blank), death is said
to have occurred on the date stated above, at 3 a.m.
Cause of Death: Pul. tuberculosis
Date of onset: 1934
Contributory causes: (blank)
Name of operation: None Was there an autopsy:
No
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: none
Nature of injury: (blank)
Related to occupation: no
Signed/Address: R. D. Collins, M.D., Whitesburg, Ky.
Transcribed by Debbie Tamborski, 22 April 2010 |
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