Date:   29 May 1943
Cert:   15263 
Place of Death: County: Knott     City or Town: Garrett on Jones Fork
Street No. or Location:  This rural part of Garrett is in Knott Co.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.      County: Knott
City or Town:  Garrett (Rural)  If rural give precinct:  on Jones Fork in Knott Co.
Full Name:  Manda Jane CHAFFINS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of:  Ellis CHAFFINS
Age of husband or wife if alive:  54 years
Birth date of deceased:  March 1888
Age: 55 years, 02 months
Birthplace:  Floyd Co., Ky.
Occupation:  (blank)
Industry or business: (blank)
Father Name:  A. J. Allen
Father Birthplace:  Boyd Co., Ky.
Mother Maiden Name:  Florence STEPHEN
Mother Birthplace:  Floyd Co., Ky.
Informant:  Mrs. M. M. COLLINS, Lackey, Ky.
Burial Place:  Garrett Cem.
Date:  30 May 1943
Signature of funeral director: W. J. Ryan, Martin, Ky. sold casket
Date received by local registrar:  19 March 1945
Registrar's Signature:  Per B. Carns
Date of Death:  29 May 1943
I hereby certify that I attended deceased from 28 May to (blank), that I last saw him alive on (blank), and that death occurred on the date stated above at 1:30 a.m.
Immediate cause of death:  (blank)
Duration: (blank)
Due to: Bad heart & Dropsy col. condition
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:  19 March 1945
Transcribed by Debbie Tamborski, 20 October 2010