Date:    03 January 1945
Cert:    13026 
Place of Death: County: Knott  City or Town: Leburn, 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:  Leburn     Rural 
Full Name:  Della CLICK 
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:  01 November 1901 
Age:  43 years, 02 months, 02 days
Birthplace:  Leburn, Ky. 
Occupation:  Housewife 
Industry or business: (blank)
Father Name:  Ben CLICK 
Father Birthplace:  Scott Co., Virginia 
Mother Maiden Name:  Randa 
Mother Birthplace:  Soft Shell, Ky. 
Informant:  Randa (her X mark) CLICK, Leburn, Ky. 
Burial Place:   Leburn, Ky. 
Date:  05 January 1945 
Signature of funeral director: Mother directed, Leburn, Ky.
Date received by local registrar:  21 May 1945 
Registrar's Signature: Rose B. Craft
Date of Death:  03 January 1945 
I hereby certify that I attended deceased from (blank) to (blank), that I last saw him alive on (illegible), and that death occurred on the date stated above at (blank)
Immediate cause of death:   (blank)
Duration: (blank)
Due to:  Epilepsy
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:  J. W. Duke, M.D., Hindman, Ky.
Date signed:  11 June 1945 
Transcribed by Debbie Tamborski, 26 November 2010