Date: 11 June 1955
Cert: #12145
Place of Death: County: Knott City or Town:
Rural
Length of stay (in this place): 06 hours
Street Address or Location: Garrett, Ky.
Usual Residence of Deceased: State: Ohio County:
Allen
City or Town: Lima, Ohio Street
Address: 148 East 10th St.
Full Name: Lee WICKER
Date of Death: 11 June 1955
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 06 July 1897
Age: 57 years
Usual Occupation: Factory worker
Kind of Industry or business: worker
Birthplace: Knott Co., Ky.
Father's Name: Alex WICKER
Mother's Maiden Name: Rhoda HICKS
Was deceased ever in armed forces: (blank)
Social Security No.: 403-10-1842
Informant: Mrs. Lee WICKER
Disease/condition directly leading to death: Coronary
Occlusion
Interval between onset and death: Sudden
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 11 June 1955 to
11 June 1955, that I last saw the deceased alive on 11 June
1955, and
that death occurred at 6 a.m., from the causes and on the
date stated above.
Date signed: 13 June 1955
Address: Garrett, Ky.
Signature: Mark Dempsey, M.D.
Burial, Cremation or Removal: Burial
Date: 13 June
Name of Cemetery or Crematory: Chaffin Cemetery
Location: Knott Co., Ky.
Date received by local registrar: 17 June 1955
Registrar's Signature: Myrtle Slone
Funeral director & address: John N. Taul, Mt.
Sterling, Ky., Eastin Richey Funeral Home
Transcribed by Debbie Tamborski, 14 May 2011 |