Date:    22 July 1947
Cert:    20404 
Place of Death: County: Knott   City or Town:  Bolyn
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.     County:  Knott
City or Town:  Bolyn 
Full Name:  Nancy BOLEN 
If Veteran Name War: (blank)
Social Security No.:  (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of:  Reece BOLEN
Age of husband or wife if alive: 62 years
Birth date of deceased:  11 November 1885 
Age:  61 years, 08 months, 11 days
Birthplace:  Floyd Co., Ky. 
Occupation:  Housewife 
Industry or business:  (blank)
Father Name:   Press CONLEY
Father Birthplace:  Knott Co., Ky. 
Mother Maiden Name:   Mary BOLEN 
Mother Birthplace:   Floyd Co., Ky. 
Informant:  Reece BOLEN, Bolyn, Ky. 
Burial Place:   Bolyn, Ky. 
Date:   24 July 1947 
Signature of funeral director:  W. J. Ryan, Martin, Ky.
Date received by local registrar:  26 September 1947 
Registrar's Signature:  Rose B. Craft
Date of Death:  22 July 1947 
I hereby certify that I attended deceased from 21 July 1947 to 22 July 1947, that I last saw him alive on 22 July 1947, and that death occurred on the date stated above at 6:00 a.m.
Immediate cause of death:  General Peritonitis 
Duration: 3 or 4 days
Due to:  Cause unknown
Other conditions:  Dying when I saw her
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work:  (blank)
Means of injury: (blank)
Signature & Address:  Paul B. Hall, M.D., Paintsville, Ky.
Date signed:  25 September 1947 
Transcribed by Debbie Tamborski, 16 December 2010