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DEATH
CERTIFICATE
JENNIE CONLEY
Date 22 November 1936
Cert: 29154
Place of Death: Voting Pct.: No. 16, Grayson, Carter Co., Ky.
Full Name: Jennie CONLEY
Residence: Stinson, Ky.
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: James CONLEY
Date of Birth: March 1866
Age: 70 years, 08 months
Occupation: Housewife
Birthplace: Knot Co., Ky.
Father Name: Jack GAYHART
Birthplace Father: Knot Co., Ky.
Mother Maiden Name: Rebecca FULLER
Birthplace Mother: Knot Co., Ky.
Informant/Address: Will CONLEY, Huntington, W. Va.
Burial Cremation Removal Place: Stinson
Date: 23 November 1936
Undertaker/Address: Frank M. Malone, Grayson, Ky.
Filed: 23 November 1936
Registrar: C. H. Jones
Death of Date: 22 November 1936
I hereby certify, That I attended deceased from April 1936 to
November 1936, that I last saw her alive on 17 November 1936, death is said
to have occurred on the date stated above, at (blank)
Cause of Death: Chronic interstitial nephritis
Date of onset: (blank)
Contributory causes: (blank)
Name of operation: (blank)
Accident, suicide, homicide: (blank)
Date of Injury: (blank)
Where did injury occur: (blank)
Specify whether injury occurred industry, home, public place:
Manner of injury: (blank)
Nature of injury: (blank)
Related to occupation: (blank)
Signed/Address: J. (illegible) Stevall, M.D., Grayson, Ky.
Transcribed by Debbie Tamborski, 18 April 2010 |
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