Date: 15 September 1949
Cert: 19070
Place of Death: County: Knott
City or Town: Vest, Ky. Rural
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Vest Rural Street Address:
(blank)
Full Name: Alice CONLEY
Date of Death: 15 September 1949
Sex, Color/Race, Marital Status: Female, White, Never Married
Date of Birth: May 1946
Age: 03 years
Usual Occupation: None
Kind of Industry or business: None
Birthplace: Knott Co., Ky.
Father's Name: Louis CONLEY
Mother's Maiden Name: Herma DOBSON
Was deceased ever in armed forces: No
Social Security No.: None
Informant: (blank)
Disease/condition directly leading to death:
Child crushed by truck
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: Accident
Place of injury: On road in front of home
City or Town, County, State: (Rural) Vest, Knott, Ky.
Time of Injury: 1949 at 1 p.m.
Injury occurred at work: Not while at work
How did injury occur: Child running to meet father, fell off
bank & was crushed under wheels of truck
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: 30 September 1949
Address: Hindman, Ky.
Signature: J. W. Duke, M.D.
Burial, Cremation or Removal: Burial
Date: 16 September 1949
Name of Cemetery or Crematory: Conley Cemetery
Location: (blank)
Date received by local registrar: 30 September 1949
Registrar's Signature: Rose B. Craft
Funeral director & address: Friends, Bolyn, Ky.
Transcribed by Debbie Tamborski, 04 January 2011 |