DEATH CERTIFICATE

WILLIAM RICE BOLEN

Date:  04 November 1953
Cert:  23321 
Place of Death: County: Knott      City or Town: Rural
Length of stay (in this place): All of life
Street address or location:  Bolyn, Ky.
Usual Residence of Deceased: State: Ky.     County: Knott
City or Town:  Rural      If rural give location:  Bolyn, Ky.
Full Name:  William Rice BOLEN
Date of Death:  04 November 1953
Sex, Color or Race, Marital Status:  Male, White, Married
Date of Birth:  30 May 1883
Age:  70 years
Usual Occupation:  Farmer
Kind of Industry or business: Farming
Birthplace:  Knott Co., Ky.
Father's Name:  W. W. BOLEN
Mother's Maiden Name:  Nancy HOLLIDAY
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant:  Oscar BOLEN
Disease or condition directly leading to death: Pulmonary Tuberculosis
Interval between onset and death:  years
Due to:  (blank)
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 (blank) to (blank), that I last saw the deceased alive on (blank), and that death occurred at (blank), from the causes and on the date stated above.
Date signed:  05 November 1953
Address:  Hindman, Ky.
Signature:  Jno. N. Taul (Coroner)
Burial, Cremation or Removal:  Burial
Date:  07 November 1953
Name of Cemetery or Crematory: Bolen Cemetery
Location:  Bolyn, Ky., Knott Co.
Date received by local registrar:  28 November 1953
Registrar's Signature:  Rose B. Craft
Funeral director & address:  John N. Taul, Hindman, Ky.
Transcribed by Debbie Tamborski, 07 February 2011