Death Certificate
William Robert Hodge

Submitted by  Kathy Hines

  Kentucky Certificate of Death - marked "DELAY"
  Registration District No. 835
  Primary Registration District No. 231-R
  File No. 25120
  Registered No. 13
  County Laurel
  Vot. Pct.:
  City or town: London
  No. Pennington General Hospital

  Full Name: William Robert Hodge
  Sex: M
  Color: White
  Marital Status: Married
  If married, widowed, or divorced HUSBAND of or WIFE of: Lula Hodge
  Date of Birth of deceased: March 12, 1876
  Age: 60 yrs, mos., dys.

  Occupation: Farmer
  Birthplace: Clay Co Ky
  Name of Father: Lube Hodge
  Birthplace of Father: Ky
  Maiden Name of Mother: Martha J. May
  Birthplace of Mother: Laurel Co Ky
  Informant's own signature: Mrs. Lula Hodge
  (Address) La[ui/m?]ers Ky
  Burial, cremation, or removal: Symbol, Ky Date of burial: July 31, 1936
  Undertaker: A.W. Rawlings
  (Address) London Ky
  Filed: 10-10, 1936 OD Brock Registrar

  [right hand column of the death certificate]
  Date of Death: July 30, 1936
  I Hereby Certify That I attended deceased from July 28, 1936 to July 30, 1936. I last saw him
  alive on July 30, 1936, and that death is said to have occurred on the date stated above, at
  5:15 Pm.
  Cause of Death: Peritonitis
  Date of onset: 7-28-36
  Contributory Causes of importance not related to principal cause: Shock 7-28-36
  Hemorrhage 7-28-36
  Name of Operation: Closure Perforations Date of: 7-28-36
  Was there an autopsy?: No
  If death was due to external causes (violence) fill in also the following: HOMICIDE Date of
  injury: 7-28-36
  Where did injury occur? Laurel Co Ky
  Specify whether injury occurred in industry, in home, or in pulbic place. Public Place
  Manner of injury: Gunshot wound of abdomen
  Nature of injury: Perforations of Colon
  Was disease or injury in any way related to occupation of deceased? No
  (Signed) W.G. Pennington, M.D.
  (Address) London Ky

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