Date:    11 November 1948
Cert:    27404 
Place of Death: County: Knott   City or Town: Lackey
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Garrett    County:  Floyd
City or Town:  Lackey 
Full Name:  Raymond CHAFFINS 
If Veteran Name War: (blank)
Social Security No.:  (blank)
Sex, Color or Race, Marital Status:  Male, White, Single
Husband or Wife of:  (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased:  02 November 1934 
Age:  14 years, 00 months, 09 days
Birthplace:  Garrett 
Occupation:  (blank) 
Industry or business:  (blank)
Father Name:  Rufus CHAFFINS 
Father Birthplace:  Floyd Co. 
Mother Maiden Name:  Linzy TUTTLE 
Mother Birthplace:   Floyd Co. 
Informant:  Hershall TURNER, Garrett, Ky. 
Burial Place:   Garrett 
Date:  13 November 1948 
Signature of funeral director:  W. J. Ryan, Martin, Ky.
Date received by local registrar: 06 January 1949 
Registrar's Signature:  Rose B. Craft
Date of Death:  11 November 1948 
I hereby certify that I attended deceased from 11 November 1948 to 11 November 1948, that I last saw him alive on 11 November 1948, and that death occurred on the date stated above at 8:35 p.m.
Immediate cause of death:  Circulatory collapse
Duration: (blank)
Due to:  toxic reaction to vermifuge worm medicine
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:  C. M. Aker, M.D., Lackey, Ky.
Date signed:  31 December 1948 
Transcribed by Debbie Tamborski, 22 December 2010