Date:    26 January 1945
Cert:    06256 
Place of Death: County: Knott  City or Town: Bolyn, Ky.  Rural
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:  Bolyn  Rural     If rural give precinct:  Rock Fork 
Full Name:  Nancy BOLEYN 
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status:  Female, White, Widowed
Husband or Wife of:  Wheatley BOLEYN
Age of husband or wife if alive: (blank)
Birth date of deceased:  13 September 1861 
Age:  83 years, 04 months, 13 days
Birthplace:  Perry Co., Ky. 
Occupation:  Housewife 
Industry or business: (blank)
Father Name:  John HOLLIDAY 
Father Birthplace:  Johnson Co., Ky. 
Mother Maiden Name:   Catherine TYREE 
Mother Birthplace:   Breathitt Co., Ky. 
Informant:   J. M. BOLEYN, Bolyn, Ky. 
Burial Place:  Bolyn, Ky. 
Date:   29 January 1945 
Signature of funeral director:  J. M. Boleyn, Bolyn, Ky.
Date received by local registrar: 29 March 1945 
Registrar's Signature:   Rose B. Craft
Date of Death:  26 January 1945 
I hereby certify that I attended deceased from 23 July 1943 to 26 January 1945, that I last saw her alive on 15 January 1945, and that death occurred on the date stated above at 3:20 p.m.
Immediate cause of death:  Cancer of face 
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:  Mark Dempsey, M.D., Garrett, Ky.
Date signed:  28 March 1945 
Transcribed by Debbie Tamborski, 26 November 2010