Date: 01 June 1955
Cert: #12147
Place of Death: County: Knott City or Town:
Red Fox - Rural
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Red Fox - Rural Street Address: (blank)
Full Name: Jephety WATTS
Date of Death: 01 June 1955
Sex, Color or Race, Marital Status: Male, White, Widowed
Date of Birth: 01 January 1880
Age: 75 years
Usual Occupation: Farmer
Kind of Industry or business: (blank)
Birthplace: Letcher Co., Ky.
Father's Name: Silas WATTS
Mother's Maiden Name: Sally CAUDILL
Was deceased ever in armed forces: (blank)
Social Security No.: no
Informant: Mrs. Herman MARTAN
Disease/condition directly leading to death: Acute Heart
failure
Interval between onset and death: Instant
Due to (b): Coronary Thrombosis
Due to (c): Hypertensive Heart Disease
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from June 1951 to 01
June 1955, that I last saw the deceased alive on 26 May 1955, and
that death occurred at 8 p.m., from the causes and on the
date stated above.
Date signed: 06 June 1955
Address: Allock
Signature: A. B. Pigman, M.D.
Burial, Cremation or Removal: Burial
Date: 04 June 1955
Name of Cemetery or Crematory: Frazier
Location: Premium, Ky.
Date received by local registrar: 02 June 1955
Registrar's Signature: Myrtle Slone
Funeral director & address: John Everage, Hindman,
Ky.
Transcribed by Debbie Tamborski, 14 May 2011 |