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DEATH
CERTIFICATE
MART WICKER
Date 13 January 1940
Cert: 00848
Place of Death: County: Floyd City or Town:
Lackey
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Lackey
City or Town: Lackey Street No.:
Lackey 33
Full Name: Mart WICKER
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Divorced
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: ? [sic]
Age: about 41 years
Birthplace: Knott County, Ky.
Occupation: Miner
Industry or business: Coal
Father Name: West WICKER
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Sally TRIPLETT
Mother Birthplace: Ky.
Informant: W. M. WICKER, Lackey
Burial Place: Lackey
Date: 15 January 1940
Signature of funeral director: E. P. Arnold, Prestonsburg, Ky.
Date received by local registrar: 15 January 1940
Registrar's Signature: Mrs. Ben Norris
Date of Death: 13 January 1940
I hereby certify that I attended deceased from (blank) to
killed by Gun shot wound, that I last saw him alive on
instantly 13 January 1940, and that death
occurred on the date stated above at 10:30 p.m.
Immediate cause of death: Gun shot wound Head & Chest
Duration: (blank)
Due to: Instant Death
Major findings of operations: (blank)
Accident, suicide, or homicide: Homicide
Date of occurrence: 13 January 1940
Where did injury occur: on hiway [sic]
While at work: no
Means of injury: gunshot
Signature & Address: A. J. Davidson, M.D.,
Prestonsburg, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 11 May 2010 |
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