DEATH CERTIFICATE

ROBERT LEE VANCE

Date:  10 June 1940
Cert:  15188
Place of Death: County: Knott     City or Town:  May
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:  May, Ky.
Full Name:  Robert Lee VANCE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status:  Male, White, Single
Husband or Wife of:  (blank)
Age of husband or wife if alive:  (blank)
Birth date of deceased:  14 January 1895
Age:  45 years
Birthplace:  Knott 
Occupation:  Farmer
Industry or business: (blank)
Father Name:  Osten VANCE
Father Birthplace:  Knott
Mother Maiden Name:  Lize PIGMAN
Mother Birthplace:  Knott
Informant:  Liza COLLINS, May, Ky.
Burial Place:  Ivan
Date:  11 June 1940
Signature of funeral director:  (blank)
Date received by local registrar:  24 June 1940
Registrar's Signature:  Macie Miller
Date of Death:  10 June 1940
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: Pneumonia
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:  J. W. Duke, M.D., Hindman
Date signed:  24 June 1940
Transcribed by Debbie Tamborski, 07 October 2010