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of William Robert Hodge 1936 |
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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