Date:   15 January 1944
Cert:   14389 
Place of Death: County: Knott   City or Town: Hollybush, 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:  Hollybush, Ky.     Rural 
Full Name:  Lula CAUDILL (Jasper's wife) 
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status:  Female, White, Married
Husband or Wife of:  Jasper CAUDILL
Age of husband or wife if alive: 41 years
Birth date of deceased:  17 March 1903 
Age:  40 years,  09 months, 28 days
Birthplace:  Knott Co., Ky. 
Occupation:   Housewife 
Industry or business: Housekeeping
Father Name:  Charley SHORT 
Father Birthplace:  Knott Co., Ky. 
Mother Maiden Name:   Susan STURGILL 
Mother Birthplace:  Knott Co., Ky. 
Informant:   Mazel CAUDILL, Hollybush, Ky. 
Burial Place:  Hollybush, Ky. 
Date:  16 January 1944 
Signature funeral director: Henery C. CAUDILL, Hollybush, Ky.
Date received by local registrar:   29 June 1944
Registrar's Signature:  Ida Livingston
Date of Death:  15 January 1944 
I hereby certify that I attended deceased from 08 January 1944 to 15 January 1944, that I last saw her alive on 08 January 1944, and that death occurred on the date stated above at (blank)
Immediate cause of death:  Broncho Pneumonia Fever 
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:  22 June 1944 
Transcribed by Debbie Tamborski, 08 November 2010