Bath County, Kentucky death certificate of Carrie Warner Staton

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Date: Sun, 26 Jan 2003
Darrell Warner
From: http://www.genrecords.net/emailregistry/vols/00001.html#0000008
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KENTUCKY DEATH CERTIFICATE
File number: 116 62 2061
Registrar's number: 9
Registration district number: 50
Primary registration district number: 2025
1.Place of death
   a. County: Bath
   b. City or town: Owingsville
   c. Length of stay in this place: nothing listed
   d. Full name of hospital or institution: none listed
2. Usual residence
   a. State: Kentucky
   b. County: Bath
   c. City or town: Owingsville    Is residence on a farm: no
   d. Street address: none listed  Is residence inside city limits: yes
3. Name of deceased
   a. First: Carrie
   b. Middle: Warner
   c. Last: Staton
4. Date of death: January 25, 1962
5. Sex: female
6. Color or race: white
7. Married, never married, widowed or divorced: married
8. Date of birth: February 28, 1884
9. Age: 77
10a. Usual occupation: housewife
10b. Kind of business or industry: nothing listed
11. Birthplace: Bath County, Kentucky
12. Citizen of what country: USA
13. Father's name: Andy Warner
14. Mother's maiden name: Betty Reynolds
15. Was deceased ever in U.S. Armed Forces: no
16. Social security number: nothing listed
17. Informant: Mrs. Ray Manley
18. Cause of death:
   a. Immediate cause: diabetic acedoris
   b. Due to: diabetic mellitus uncontrolled
   c. Due to: nothing listed
19. Was autopsy performed: no
20. Accident, suicide, or homicide: nothing marked
21a. Describe how injury occurred: nothing listed
21b. Time of injury: nothing listed
22. I hereby certify that I attended the deceased from July 1961 to 
January 1962 that I last saw the deceased alive January 25, 1962 and that 
death occurred at 5:00 PM from the causes and on the date stated above.
23a. Date signed: January 26, 1962
23b. Address: Owingsville, Kentucky
23c. Signature: Edwin R. Davis MD
24a. Burial, cremation, removal: burial
24b. Date: January 27, 1962
24c. Name of cemetery or crematory: Owingsville
24d. Location: Owingsville, Kentucky
25a. Date received by local registrar: January 27, 1962
25b. Registrar's signature: Lena R. Brooks
26. Funeral director: Fred Keal,  Keal Funeral Home, Owingsville, Kentucky