Date:   21 November 1943
Cert:   27640 
Place of Death: County: Knott  City or Town: Sassafras, Ky., Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky   County: Knott
City or Town:  Sassafras, Ky., Rural
Full Name:  Surrilda CORNETT
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of:  Dixon CORNETT
Age of husband or wife if alive:  72 years
Birth date of deceased:  02 April 1878
Age: 65 years, 07 months, 19 days
Birthplace:  Fisty, Ky.
Occupation:  Housewife
Industry or business:  House keeping
Father Name:  Joshua RITCHIE
Father Birthplace:  Fisty, Ky.
Mother Maiden Name:  Nancy RITCHIE
Mother Birthplace:  Fisty, Ky.
Informant:  Isma C. BANKS, Sassafras, Ky.
Burial Place:  Sassafras, Ky.
Date:  23 November 1943
Signature of funeral director:  Maggard Funeral Home, Hazard, Ky.
Date received by local registrar: 05 December 1944
Registrar's Signature:  Ida Livingston  Rose B. Craft, Acting Reg.
Date of Death:  21 November 1943
I hereby certify that I attended deceased from (blank) to (blank), that I last saw him alive on (blank), and that death occurred on the date stated above at (blank)
Immediate cause of death: Mitral insufficiency
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: R. L. Collins, M.D.
Date signed:  (blank)
Transcribed by Debbie Tamborski, 23 October 2010