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DEATH
CERTIFICATE
ESQUIRE WILLIAMS
Date 09 April 1936
Cert: 12045
Place of Death: Voting Pct.: #27, Hazard, Perry Co., Ky.
Full Name: Esquire WILLIAMS
Residence: Highland Ave.
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Male, Colored,
Divorced
Husband or Wife of: Lucinda WILLIAMS
Date of Birth: 06 May 1861
Age: 75 years, 11 months, 03 days
Occupation: Janitor - Private Homes
Birthplace: Knott Co., Ky.
Father Name: Henry WILLIAMS
Birthplace Father: Knott Co., Ky.
Mother Maiden Name: Phoebee ADAMS
Birthplace Mother: Knott Co., Ky.
Informant/Address: Mattie BAILEY, Hazard, Ky.
Burial Cremation Removal Place: Smithsboro, Ky.
Date: 10 April 1936
Undertaker/Address: Willard K. Williams, Hazard, Ky.
Filed: 13 April 1936
Registrar: J. P. Boggs
Death of Date: 09 April 1936
I hereby certify, That I attended deceased from (blank) to
(blank), that I last saw h-- alive on (blank), death is said
to have occurred on the date stated above, at 4:05 a.m.
Cause of Death: General Senility
Date of onset: 1935
Contributory causes: Arterio sclerosis
Date of onset: 1930
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: No
Signed/Address: J. C. Coldiron, M.D., Hazard, Ky.
Transcribed by Debbie Tamborski, 21 April 2010 |
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