Date: 02 June 1948
Cert: 17043
Place of Death: County: Knott City or
Town: Lackey, Ky. Rural
Name of Hospital or Institution: Stumbo Memorial Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Mousie Rural
Full Name: Eddie Lee WATTS
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: 18 May 1936
Age: 12 years, 00 months, 14 days
Birthplace: Mousie, Ky.
Occupation: School boy
Industry or business: (blank)
Father Name: Hagar WATTS
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Alafair CONLEY
Mother Birthplace: Knott Co., Ky.
Informant: Mrs. Jahoza CONLEY, Mousie, Ky.
Burial Place: Mousie, Ky.
Date: 04 June 1948
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: 22 August 1948
Registrar's Signature: Rose B. Craft
Date of Death: 02 June 1948
I hereby certify that I attended deceased from 31 May 1948 to
02 June 1948, that I last saw him alive on 02 June 1948, and
that death occurred on the date stated above at 7:00 a.m.
Immediate cause of death: circulatory failure
Duration: (blank)
Due to: 3rd degree burns
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: C. M. Aker, M.D., Lackey, Ky.
Date signed: 10 August 1948
Transcribed by Debbie Tamborski, 29 December 2010 |