Date: 20 November 1953
Cert: 27436
Place of Death: County: Knott
City or Town: Cody, Ky. Rural
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky.
County: Perry
City or Town: Viper Rural If rural give
location:
(blank)
Full Name: Ardelia WOODS
Date of Death: 20 November 1953
Sex, Color or Race, Marital Status: Female, White,
Married
Date of Birth: 13 March 1875
Age: 78 years
Usual Occupation: Housewife
Kind of Industry or business: (blank)
Birthplace: Knott Co., Ky.
Father's Name: Squire WATTS
Mother's Maiden Name: Sally CAMPBELL
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Marie HILTON
Disease or condition directly leading to death: Congestive
Heart Failure
Interval between onset and death: 01 year
Due to: Hypertension
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 20 May 1953 to
04 June 1953, that I last saw the deceased alive on 04 June
1953, and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: 15 December 1953
Address: Hazard, Ky.
Signature: Martin Palmer, M.D.
Burial, Cremation or Removal: Burial
Date: 22 November 1953
Name of Cemetery or Crematory: Cornett Cemetery
Location: Viper, Ky.
Date received by local registrar: 13 February 1954
Registrar's Signature: Mrs. Rose B. Craft
Funeral director & address: John Everage, Hindman,
Ky.
Transcribed by Debbie Tamborski, 12 February 2011 |