Nancy Ann (Johnson) Hodges
Submitted by: Kathy Hines
Kentucky Certificate of
Registration District No. 835
Primary Registration District No. 6451
File No. 14424
Registered No. 73
City or town: Rural
Name of hospital or facility: Maplesville P.O.
Full Name: Nancy Ann
Marital Status: M
Name of HUSBAND or WIFE: Robert Hodges
Age of husband or wife if alive: 77 years
Date of Birth of deceased: Jan 22, 1867
Age: 77 yrs, 5 mos., 0 dys.
Birthplace: Laurel Co Ky
Name of Father: Hiram Johnson
Birthplace of Father: Laurel Co.
Maiden Name of Mother: Patsy Keen
Birthplace of Mother: Tenn.
Informant's own signature: Sim Hodges
(Address) Maplesville Ky Laurel Co.
Burial, cremation, or removal: Old Salem Cem. Date of burial: June 23, 1944
Undertaker: House Funeral Home
(Address) London Ky
Filed: 7-8, 1944 Ruth Gaines Registrar
[right hand column of the
Usual residence of deceased: Kentucky, Laurel, Maplesville
If foreign born, how long in the U.S.A.? Native
Date of Death: June 22, 1944
I Hereby Certify That I attended deceased from --, 1944 to June 22, 1944. I last saw him alive
on June 10, 1944, and that death is said to have occurred on the date stated above, at 7 Am.
Cause of Death: Diabetic Gangrene
Major findings of operations: 61
(Signed) J.W. Crook, M.D.
(Address) London Ky Date signed: [blank]