Date:  15 February 1954
Cert:  #16289 
Place of Death: County: Knott    City or Town: Rural Bolyn, Ky.
Length of stay (in this place): all life
Street address or location:  On Rock Fork
Usual Residence of Deceased: State: Ky.     County: Knott
City or Town: Rural - Bolyn    If rural give location: On Rock Fork
Full Name:  Nancy Dean BOLEN
Date of Death:  15 February 1954 
Sex, Color/Race, Marital Status: Female, White, Never Married
Date of Birth:  12 February 1954
Age:  03 days
Usual Occupation:  None
Kind of Industry or business: None
Birthplace:  Bolyn, Ky., Knott 
Father's Name:  Jimmie Ray BOLEN 
Mother's Maiden Name:  Ethel RAMEY 
Was deceased ever in armed forces: no
Social Security No.:  none
Informant:  Ethel RAMEY the mother 
Disease/condition directly leading to death: congenital weakness
Interval between onset and death:  all life
Due to:  not known
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy:  (blank)
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 12 February 1954 to 12 February 1954, that I last saw the deceased alive on 12 February 1954, and that death occurred at (illegible), from the causes and on the date stated above.
Date signed:  24 February 1954
Address:  Garrett, Ky.
Signature:  Mark Dempsey, M.D.
Burial, Cremation or Removal: Burial
Date:  16 February 1954
Name of Cemetery or Crematory: Conley
Location:  on Rock Fork, Ky.
Date received by local registrar: 30 June 1954
Registrar's Signature: Mrs. Rose B. Craft
Funeral director & address:  none recorded
Transcribed by Debbie Tamborski, 12 March 2011