Date:  08 February 1955
Cert:  #03216
Place of Death: County: Knott      City or Town: Anco - Rural
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky.      County: Knott
City or Town: Anco - Rural     Street Address: (blank)
Full Name:  Polly Ann COMBS
Date of Death:  08 February 1955
Sex, Color or Race, Marital Status:  Female, White, Widowed
Date of Birth:  15 October 1874
Age: 80 years 
Usual Occupation: Housewife
Kind of Industry or business: (blank)
Birthplace:  Perry Co., Ky.
Father's Name:  Samuel COMBS
Mother's Maiden Name:  Matilda YOUNG
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant:  (blank)
Disease or condition directly leading to death:  Senility
Interval between onset and death:  (blank)
Due to:  (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 15 November 1954 to 08 February 1955, that I last saw the deceased alive on 07 February 1955, and that death occurred at 7 p.m., from the causes and on the date stated above.
Date signed:  28 February 1955
Address:  Allock
Signature:  A. B. Pigman, M.D.
Burial, Cremation or Removal: Burial
Date:  11 February 1955
Name of Cemetery or Crematory:  Family
Location:  Anco, Ky.
Date received by local registrar:  26 February 1955
Registrar's Signature: Myrtle Slone
Funeral director & address:  John Everage, Hindman, Ky.
Transcribed by Debbie Tamborski, 14 May 2011