Kit Carson KNOWLES Death Certificate

TEXAS DEPARTMENT OF HEALTH

BUREAU OF VITAL STATISTICS

STATE OF TEXAS

CERTIFICATE OF DEATH

STATE FILE NO.: 17844

1. PLACE OF DEATH

a. COUNTY: HIDALGO

b. CITY OR TOWN: San Juan

c. LENGTH OF STAY in 1b.: 7 days

d. NAME OF HOSPITAL OR INSTITUTION: San Juan Hospital

e. IS PLACE OF DEATH INSIDE CITY LIMITS? Yes

2. USUAL RESIDENCE

a. STATE: Texas

b. COUNTY: Hidalgo

c. CITY OR TOWN: Donna

d. STREET ADDRESS: 423 N. 13 St.

e. IS RESIDENCE INSIDE CITY LIMITS? Yes

f. IS RESIDENCE A FARM? No

3. NAME OF DECEASED: Kit Carson Knowles

4. DATE OF DEATH: March 6, 1960

5. SEX: Male

6. COLOR OR RACE: Caucasian

7. Married

8. DATE OF BIRTH: March 13, 1888

9. AGE: 71

10a. USUAL OCCUPATION: Plant Engineer

10b. KIND OF BUSINESS OR INDUSTRY: Food Processing

11. BIRTHPLACE: Texas

12. CITIZEN OF WHAT COUNTRY? United States

13. FATHER'S NAME: S. A. Knowles

14. MOTHER'S MAIDEN NAME: Narcissus Walker

15. WAS DECEASED EVER IN U.S. ARMED FORCES? Yes, WW I

16. SOCIAL SECURITY NO.: 449-10-7726

17. INFORMANT: James M. Hepner

MEDICAL CERTIFICATION

18. CAUSE OF DEATH

PART I. DEATH WAS CAUSED BY:

IMMEDIATE CAUSE: uremia

INTERVAL BETWEEN ONSET AND DEATH: 3 days

DUE TO: Kidney failure due to

INTERVAL BETWEEN ONSET AND DEATH: 2 weeks

DUE TO: carcinomatosis - primary bronchogenic

INTERVAL BETWEEN ONSET AND DEATH: 10 mos.

PART II. OTHER SIGNIFICANT CONDITIONS...: None

19. WAS AUTOPSY PERFORMED? No

20a-f. [blank]

21. I hereby certify that I attended the deceased from 8/11/59, 19[blank], to 3/6/60, 19[blank], and last saw the deceased alive on 3/6/60, 19[blank]. Death occurred at 7:15 p.m. on the date stated above, and to the best of my knowledge, from the causes stated.

22a. SIGNATURE: Thomas M. Carleton, M.D.

22b. ADDRESS: 914 Miller St, Donna

22c. DATE SIGNED: 3/7/60

23a. BURIAL, CREMATION, REMOVAL: Removal

23b. DATE: March 6, 1960

23c. NAME OF CEMETERY OR CREMATORY: Highland Memorial Park Cemetery

23d. LOCATION: Hidalgo County, Texas

24. FUNERAL DIRECTOR'S SIGNATURE: D. H. Stotler

Stotler Mortuary F3240

D. H. Stotler E2636

25a. REGISTRAR'S FILE NO.: 17

25b. DATE REC'D BY LOCAL REGISTRAR: March 10, 1960

25c. REGISTRAR'S SIGNATURE: J. F. Crutchfield