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DEATH
CERTIFICATE
VANZLE WATTS
Date: 12 March 1951
Cert: 08308
Place of Death: County: Perry City or Town:
Viper
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky. County:
Perry
City or Town: Viper Street Address: (blank)
Full Name: Vanzle WATTS
Date of Death: 12 March 1951
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 07 November 1894
Age: 56 years, 04 months, 25 days
Usual Occupation: Farmer
Kind of Industry or business: Agriculture
Birthplace: Leburn, Ky.
Father's Name: Harlan WATTS II
Mother's Maiden Name: Dora ADAMS
Was deceased ever in armed forces: (blank)
Social Security No.: 403-16-4387
Informant: Mrs. Vanzle WATTS
Disease or condition directly leading to death: Apoplexy
Interval between onset and death: 01 day
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
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 12 March 1951
to 12 March 1951, that I last saw the deceased alive on
(blank), and that death occurred at (blank), from the causes
and on the date stated above.
Date signed: 29 March 1951
Address: Hazard, Ky.
Signature: J. C. Coldiron, M.D.
Burial, Cremation or Removal: (blank)
Date: 1951
Name of Cemetery or Crematory: Viper, Ky.
Location: Viper, Ky.
Date received by local registrar: 04 April 1951
Registrar's Signature: Georgia P. Surer
Funeral director & address: none
Transcribed by Debbie Tamborski, 31 July 2010 |
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