Full Name:  Maggie Cox      

COMMONWEALTH OF KENTUCKY
Department of Health
Division Of Vital Statistics
CERTIFICATE OF DEATH
        File No. 116    69 26113
        Registrarās No. 378

Registration District No. 60           Primary Registration District No. 2031

Name of Deceased:   Maggie Cox           Date of Death:  October 13, 1969
County of Death:  Bell City:  Pineville      Inside City Limits:  Yes
Hospital or other Institution Name:  Pineville Community Hospital

Sex:  Female            Color or Race:   White          
Marital Status:  Married  Surviving Spouse:  Raleigh Cox
Date of Birth:  May 29, 1910   Age:  59 years
State of Birth:  KY   Citizen of what country:   USA
Residence:  State:  KY          County:  Bell    
City, Town or Location:   Calvin  Inside City Limits:  No

Fatherās Name:  Harrison Surgner  Motherās Maiden Name:  Birdie Fultz

Informant:  Raleigh Cox, Calvin, KY, 40813

Medical Certification:
Cause of Death:  (a)  Chr  nephritis ö Rheumatoid Arthritis
Due to:  (b)   secondary anurism (sic)
Autopsy:  Yes  If yes, were findings considered in determining cause of death: Yes

I attended the deceased on 10-13-69;  Death occurred at 8:20 p.m.
The decedent was pronounced dead 10-13-69 at 8:20 p.m.
Certifier name:  Charles B. Stacy, M.D.
Pineville, KY 40977

Burial, 10-16-1969   Brafford Cemetery,  Grays, KY
Funeral Director:  James S. Durham    Pineville, KY 40977
Name of Embalmer:  James S. Durham   Lic. No. 2975

Date recād by local reg.  Nov. 7, 1969;  
Registrarās Signature: Louise Hightower, Dep. Reg.

transcribed by Kristi Cox

     
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