Date: 24 June 1947
Cert: 28985
Place of Death: County: Knott City or
Town: Garrett, 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: Garrett Rural
Full Name: David CHAFFINS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Widowed
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 24 May 1860
Age: 87 years, 01 months, 00 days
Birthplace: Knott Co., Ky.
Occupation: Farmer
Industry or business: Farming
Father Name: Samuel CHAFFINS
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Nancy SUTTON
Mother Birthplace: Knott Co., Ky.
Informant: Gilbert CHAFFINS, Lukeville, Ohio
Burial Place: Garrett, Ky.
Date: 26 June 1947
Signature of funeral director: G. D. Ryan, Martin, Ky.
Date received by local registrar: 26 March 1948
Registrar's Signature: Rose B. Craft
Date of Death: 24 June 1947
I hereby certify that I attended deceased from 20 June 1947 to
24 June 1947, that I last saw him alive on 24 June 1947, and
that death occurred on the date stated above at 2:30 a.m.
Immediate cause of death: Old age & heart acted bad at
time death
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: Dr. M. M. Collins, M.D., Lackey,
Ky.
Date signed: 21 March 1948
Transcribed by Debbie Tamborski, 16 December 2010 |