Date:  18 March 1949
Cert:  10116 
Place of Death: County: Knott      City or Town:  Lackey, Ky.
Length of stay (in this place): (blank)
Name of Hospital or Institution: Stumbo Memo.
Usual Residence of Deceased: State: Ky.     County:  Knott
City or Town:  Topmost    Street Address: (blank)
Full Name:  Everage COLLINS
Date of Death:  18 March 1949
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth:  01 April 1911
Age:  37 years
Usual Occupation:  (blank)
Kind of Industry or business: Merchant
Birthplace:  Wayland, Ky.
Father's Name:  Allen COLLINS
Mother's Maiden Name:  Florence BATES
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant:  Ulysses COLLINS
Disease or condition directly leading to death:  (blank)
Interval between onset and death:  (blank)
Due to:  Drowned
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
Accident, suicide, or homicide: Accident
Place of injury:  In Beaver Creek
City or Town, County, State: Lackey, Knott, Ky.
Time of Injury: 18 March 1949, 2 p.m.
Injury occurred at work:  Not white at work
How did injury occur:  Road icy Truck ran into Creek
I hereby certify that I attended deceased from (blank) to (blank), that I last saw the deceased alive on (blank), and that death occurred at (blank), from the causes and on the date stated above.
Date signed:  19 March 1949
Address:  Martin, Ky.
Signature:  W. J. Ryan, Embalmer
Burial, Cremation or Removal:  Burial
Date:  20 March 1949
Name of Cemetery or Crematory:  Topmost
Location:  Topmost, Ky.
Date received by local registrar:  12 May 1949
Registrar's Signature:  Rose B. Craft
Funeral director & address:  G. D. Ryan, Martin, Ky.
Transcribed by Debbie Tamborski, 03 January 2011