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DEATH
CERTIFICATE
FRED WILLIAMS
Date 22 February 1944
Cert: 10376
Place of Death: County: Perry Co. City or
Town: 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: Rural
Full Name: Fred WILLIAMS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Nannie WILLIAMS
Age of husband or wife if alive: (blank)
Birth date of deceased: 27 January 1900
Age: 43 years, 11 months, 26 days
Birthplace: Morgan Co.
Occupation: Miner
Industry or business: (blank)
Father Name: W. J. WILLIAMS
Father Birthplace: Morgan Co.
Mother Maiden Name: Nancy C. CONLY
Mother Birthplace: Floyd Co.
Informant: Nannie WILLIAMS, Amburgy, Ky.
Burial Place: Amburgy, Ky.
Date: 1944
Signature funeral director: Maggard's by R. Evans, Hazard, Ky.
Date received by local registrar: 24 April 1944
Registrar's Signature: Anna L. Boulos
Date of Death: 22 February 1944
I hereby certify that I attended deceased from 22 February
1944 to
22 February 1944, that I
last saw him alive on 22 February 1944, and that death
occurred on the date stated above at (blank)
Immediate cause of death: Electrocution
Due to: mine accident
Major findings of operations: (blank)
Accident, suicide, or homicide: Accident
Date of occurrence: 22 February 1944
Where did injury occur: mine accident
While at work: yes
Means of injury: electrocution
Signature: Chris S. Jackson, M.D., Hazard, Ky.
Date signed: 19 April 1944
Transcribed by Debbie Tamborski, 08 February 2010 |
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