Date: 07 March 1944
Cert: 07541
Place of Death: County: Knott City or
Town: Pippapass, Ky.
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Pippapass, Ky. Rural
Full Name: ALLEN Mrs. Rhoda Reynolds
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: Sam ALLEN
Age of husband or wife if alive: (blank)
Birth date of deceased: 28 February 1890
Age: 54 years, 00 months, 08 days
Birthplace: (blank)
Occupation: Housewife
Industry or business: Housekeeping
Father Name: Wesley REYNOLDS
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Mary STACY
Mother Birthplace: Knott Co., Ky.
Informant: Polly ALLEN, Pippapass
Burial Place: Cem. (illegible)
Date: 12 March 1944
Signature of funeral director: (blank), Marlin, Ky.
Date received by local registrar: (blank)
Registrar's Signature: (blank)
Date of Death: 07 March 1944
I hereby certify that I attended deceased from 01 January 1944 to
07 March 1944, that I last saw him alive on 06 March 1944, and
that death occurred on the date stated above at 8 p.m.
Immediate cause of death: Chronic heart Disease and
Disease of Stomach
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: M. F. Kelley, M.D., Hindman, Ky.
Date signed: 29 March 1944
Transcribed by Debbie Tamborski, 07 November 2010 |