DEATH CERTIFICATE

 DORTHY CONLEY

Date:   05 June 1941
Cert:   15466 
Place of Death: County: Knott     City or Town: Lackey, Ky.
Name of Hospital or Institution: Stumbo Memorial
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.      County:  Knott
City or Town:  Vest, Ky.
Full Name:  Dorthy CONLEY
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:  28 March 1925
Age: 16 years, 02 months, 09 days
Birthplace:  Vest, Ky.
Occupation:  Domestic
Industry or business: (blank)
Father Name:  Zack CONLEY
Father Birthplace:  Knott Co.
Mother Maiden Name:  Catherine STUTTON
Mother Birthplace:  Don't know
Informant:  Mrs. Hobert HAYES
Burial Place:  Vest, Ky.
Date:  07 June 1941
Signature of funeral director: G. D. Ryan, Martin, Ky.
Date received by local registrar:  24 June 1941
Registrar's Signature:  Macie Miller
Date of Death:  05 June 1941
I hereby certify that I attended deceased from 30 May 1941 to 05 June 1941, that I last saw him alive on 05 June 1941, and that death occurred on the date stated above at 8:30 p.m.
Immediate cause of death:  Ruptured appendix generalized peritonitis
Duration: (blank)
Due to: (blank)
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: W. L. Stumbo, M.D., Lackey, Ky.
Date signed:  (blank)
Transcribed by Debbie Tamborski, 11 October 2010