DEATH CERT: Adeline Heath, d. 1941, Jefferson Co., KY

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Donated by: tdeford6@cs.com
Date: 26 Jan 2002
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The typewriter really needed a good cleaning, so the letter are sometimes filled in with too much ink.

NO 26834   Registration # 5105  Registration District No 755 Primary District 6174
Place of death Jefferson Co.
City or town Rural
Name of Hospital or institution
Louisville, KY, #5 Can Run Road
Full NAME Adeline Heath
Sex Female Color White
widow
Name of Husband Tom Heath
deceased Birth date of deceased October 26-1867
age 74 years 0 months 29 days
Birthplace Grayson Co., KY
usual Occupation House Keeper
Father Wash Whobrey
birthplace Grayson Co. KY
Mother Rose Anna Minton
birthplace Grayson Co., KY
informant Mrs. Mathaw Whobrey
address Louisville KY R#?
Burial South Grayson Co., KY Nov 26-1941
funeral Director W. G. Hardy
Address W. G. Hardy Shively KY
Nov 27, 1941
Usual place of residence State Kentucky, County Grayson
City Rural South, KY
Street No. Rural
Medical Certification
date of death November 24th 1941
I hereby certify, that I attended the deceased from 11-17-1941 TO 11-24-1941,
And that I last saw her alive 11-17-1941, and death occurred on the day
stated above at 10101 AM.
Cause of death Myocarditis Duration Years
other conditions Senility Signature K. L, or it could be K. I. Kerr M. D.
Address Preston & Ba???? signed 11/26/