Date: 01 October 1950
Cert: 21019
Place of Death: County: Knott
City or Town: Rural
Length of stay (in this place): All of life
Street address or location: Mousie, Ky.
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural If rural give
precinct: Mousie, Ky.
Full Name: David WICKER
Date of Death: 01 October 1950
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 02 June 1905
Age: 45 years
Usual Occupation: Farmer
Kind of Industry or business: Farming
Birthplace: Knott Co., Ky.
Father's Name: Jesse WICKER
Mother's Maiden Name: Nancy TRIPPLETT
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: John WICKER
Disease or condition directly leading to death: Heart
condition
Interval between onset and death: (blank)
Due to: over drinking
Other significant conditions: (blank)
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 (blank) to
(blank), 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: 07 October 1950
Address: Hindman, Ky.
Signature: Jno. N. Taul (Coroner)
Burial, Cremation or Removal: Burial
Date: 03 October 1950
Name of Cemetery or Crematory: Family Cemetery
Location: Mousie, Ky.
Date received by local registrar: 07 October 1950
Registrar's Signature: Rose B. Craft
Funeral director & address: John N. Taul, Director,
Hindman Funeral Home
Transcribed by Debbie Tamborski, 17 January 2011 |