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DEATH
CERTIFICATE
Mrs. CORA CONLEY
Date 16 September 1930
Cert: 21683
Place of Death: Voting Pct: Beaver Valley Hosp., John
Possum, Floyd Co., Ky.
Full Name: Mrs. Cora CONLEY
Residence: Garrett, Ky.
Length of Residence in city where death occurred:
(blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Coet CONLEY
Date of Birth: (blank)
Age: 21 years
Occupation: Hswf.
Birthplace: Knott Co.
Father Name: Alex CHAFFINS
Birthplace Father: Garrett, Ky., Knott Co.
Mother Maiden Name: Martha Ann COMBS
Birthplace Mother: Yellow Mt., Ky.
Informant/Address: Ellis CHAFFINS, Garrett, Ky.
Filed: 17 September 1931
Registrar: Mrs. W. L. Stumbo per B. Carns
Death of Date: 16 September 1930
I hereby certify that I attended deceased from 07 September
1930 to
16 September 1930, that I last saw her alive on 16 September
1930, and that death occurred on the date stated above at 4:30
p.m.
Cause of Death: Tubes & appendix removed
Duration: (blank)
Contributory: Dysentery appendicitis
Duration: (blank)
Where was disease contracted if not at place of death?: at
Garrett, Ky.
Did an operation precede death: yes Date: 08
September
Was there an autopsy: (blank)
What test confirmed diagnosis: (blank)
Signed/Address: W. L. Stumbo, M.D., Martin, Ky.
Place of Burial or Removal: Garrett, Ky.
Date of Burial: 17 September 1930
Undertaker/Address: G. D. Ryan, Martin, Ky.
Transcribed by Debbie Tamborski, 29 March 2010 |
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