Date: 11 May 1943
Cert: 15257
Place of Death: County: Knott City or
Town: Wiscoal (Rural)
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: Jeff (Rural)
Full Name: George WHITE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: (blank)
Age: 72 years
Birthplace: (blank)
Occupation: (blank)
Industry or business: (blank)
Father Name: (blank)
Father Birthplace: (blank)
Mother Maiden Name: (blank)
Mother Birthplace: (blank)
Informant: Dr. J. R. AKERS, Anco, Ky.
Burial Place: (blank)
Date: (blank)
Signature of funeral director: Casket purchased from Engles,
Hazard, Ky.
Date received by local registrar: 26 March 1945
Registrar's Signature: Mrs. Rose B. Craft acting Per B.
Carns
Date of Death: 11 May 1943
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: Chronic Nephritis
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. R. Akers, M.D., Anco, Ky.
Date signed: 26 March 1945
Transcribed by Debbie Tamborski, 29 October 2010 |