DEATH
CERTIFICATE
CORA ALLEN
Date 17 October 1940 Cert: 24245 Place of Death: County: Knott Co. City or Town: Lackey Name of Hospital or Institution: Stumbo Memorial Hospital Length of stay in hospital or community: (blank) Usual Residence of Deceased: State: Ky. County: Floyd City or Town: Martin, Ky. Full Name: Cora ALLEN If Veteran Name War: (blank) Social Security No.: (blank) Sex, Color or Race, Marital Status: Female, White, Single (with married underlined) Husband or Wife of: Marion ALLEN Age of husband or wife if alive: 60 years Birth date of deceased: 11 March 1881 Age: 59 years, 07 months, 06 days Birthplace: Salisbury, Ky. Occupation: Domestic Industry or business: (blank) Father Name: Alex L. STUMBO Father Birthplace: McDowell, Ky. Mother Maiden Name: Louisa SALISBURY Mother Birthplace: Hunter, Ky. Informant/Address: Marion ALLEN, Printer, Ky. Burial Place: Printer Date: 21 October 1940 Signature of funeral director/Address: G. D. Ryan, Martin, Ky. Date received by local registrar: 29 October 1940 Registrar's Signature: Macie Miller Date of Death: 17 October 1940 I hereby certify that I attended deceased from 01 October 1940 to 17 October 1940, that I last saw her alive on 17 October 1940, and that death occurred on the date stated above at 11:15 a.m. Immediate cause of death: Sugar Diabetes Duration: (blank) Due to: (blank) Major findings of operations: (blank) Accident, suicide, or homicide: (blank) Date of occurrence: (blank) Where did injury occur: (blank) While at work: (blank) Means of injury: (blank) Signature & Address: W. L. Stumbo, M.D., Martin, Ky. Date signed: (blank) Transcribed by Debbie Tamborski, 16 August 2010 |