Date:    30 January 1944
Cert:    12239
Place of Death: County: Knott   City or Town:  Mousie, Ky.
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky   County: (blank)
City or Town: (blank)
Full Name:  Alpha CHAFFINS 
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status:  Female, White, Single
Husband or Wife of:  (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased:   17 July 1912
Age:  31 years, 06 months, 13 days
Birthplace:  Ky. 
Occupation:  Housework 
Industry or business: (blank)
Father Name:  Calloway CHAFFINS 
Father Birthplace: Ky. 
Mother Maiden Name: Cynthia WICKER
Mother Birthplace: Ky. 
Informant:  Caloway CHAFFINS, Mousie, Ky. 
Burial Place:  Mousie
Date:  16 January 1944 
Signature of funeral director:  Friends & Relatives, Mousie
Date received by local registrar: 31 May 1944 
Registrar's Signature: Ida Livingston
Date of Death:  30 January 1944 
I hereby certify that I attended deceased from 30 January 1944 to 30 January 1944, that I last saw him alive on 30 January 1944, and that death occurred on the date stated above at 1 a.m.
Immediate cause of death:  Chronic Empyemia 
Duration: (blank)
Due to:  (blank)
Other Conditions:  Asthma
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work:  (blank)
Means of injury: (blank)
Signature & Address: M. V. Wicker, M.D., Wayland
Date signed:  (blank) 
Transcribed by Debbie Tamborski, 08 November 2010