Date:  27 November 1953
Cert:  27434 
Place of Death: County: Knott  City or Town: Mousie, Ky. Rural
Length of stay (in this place): 10 years
Street address or location:  Pt. died at home on Jones Fork
Usual Residence of Deceased: State: Ky.     County: Knott
City or Town:  Mousie     Rural    Street Address: (blank)
Full Name: William M. BOLEN
Date of Death:  27 November 1953
Sex, Color or Race, Marital Status:  Male, White, Married
Date of Birth:  15 September 1884
Age:  69 years, 02 months, 12 days
Usual Occupation:  Farmer
Kind of Industry or business: Farming
Birthplace:  Knott County, Ky.
Father's Name:  Ransom BOLEN
Mother's Maiden Name:  Christina GAYHEART
Was deceased ever in armed forces: No
Social Security No.: None
Informant:  Mrs. Mollie BOLEN
Disease or condition directly leading to death: Hypertensive Cardiac Disease
Interval between onset and death:  (blank)
Due to:  Diabetes Mellitus
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy:  No
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 24 December 1952 to 27 November 1953, that I last saw the deceased alive on 26 November 1953, and that death occurred at 11:45 a.m., from the causes and on the date stated above.
Date signed:  27 November 1953
Address:  Garrett, Ky.
Signature:  C. B. Ison, M.D.
Burial, Cremation or Removal:  Burial
Date:  30 November 1953
Name of Cemetery or Crematory:  Bolen Cemetery
Location:  Knott Co., Ky.
Date received by local registrar: 08 December 1953
Registrar's Signature:  Mrs. Rose B. Craft
Funeral director & address:  John N. Taul, Hindman Funeral Home, Hindman, Ky.
Transcribed by Debbie Tamborski, 07 February 2011