Date: 18 June 1944
Cert: 16578
Place of Death: County: Knott City or
Town: Rural Sassafras
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: Rural Sassafras
Full Name: Carrie WATTS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Clifton WATTS
Age of husband or wife if alive: 58 years
Birth date of deceased: 18 September 1884
Age: 59 years, 09 months, 00 days
Birthplace: May, Ky.
Occupation: House wife
Industry or business: (blank)
Father Name: Bill FRANKLIN
Father Birthplace: Knott Co.
Mother Maiden Name: Nancy Anne COMBS
Mother Birthplace: Knott Co., Ky.
Informant: Clifton WATTS, Sassafras, Ky.
Burial Place: Cornett Hill
Date: 20 June 1944
Signature of funeral director: Maggard, Hazard, Ky.
Date received by local registrar: 10 July 1944
Registrar's Signature: Ida Livingston
Date of Death: 18 June 1944
I hereby certify that I attended deceased from 18 June 1944 to
18 June 1944, that I last saw him alive on 18 June 1944, and
that death occurred on the date stated above at 3:00 p.m.
Immediate cause of death: Shock
Duration: 02 hours
Due to: Crushed pelvis with ruptured (illegible)
Major findings of operations: (blank)
Accident, suicide, or homicide: accident
Date of occurrence: 18 June 1944
Where did injury occur: hyway
While at work: no
Means of injury: Car accident
Signature & Address: Chris S. Jackson, M.D., Hazard,
Ky.
Date signed: 08 July 1944
Transcribed by Debbie Tamborski, 26 November 2010 |