Date:  04 April 1955
Cert:  #7808
Place of Death: County: Knott      City or Town: Carrie - 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:  Carrie - Rural     Street Address: (blank)
Full Name:  Dallie CORNETT
Date of Death:  04 April 1955
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth:  05 December 1905
Age: 49 years
Usual Occupation:  Housewife
Kind of Industry or business: (blank)
Birthplace:  Knott Co., Ky.
Father's Name:  Dial FUGATE
Mother's Maiden Name:  Elizabeth JOHNSON
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant:  Lawrence CORNETT
Disease or condition directly leading to death: Disease of heart
Interval between onset and death:  (blank)
Due to:  Goiter
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
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 (blank) to 05 April 1955, that I last saw the deceased alive on 24 February 1955, and that death occurred at 2 a.m., from the causes and on the date stated above.
Date signed:  07 April 1955
Address:  Hindman, Ky.
Signature:  M. F. Kelley
Burial, Cremation or Removal: Burial
Date:  06 April 1955
Name of Cemetery or Crematory:  Martin Cemetery
Location:  Carrie, Ky.
Date received by local registrar:  18 April 1955
Registrar's Signature: Myrtle Slone
Funeral director & address:  John Everage, Hindman, Ky.
Transcribed by Debbie Tamborski, 14 May 2011