Date:   15 December 1942
Cert:    01852
Place of Death: County: Knott     City or Town: Lackey
Name of Hospital or Institution: Stumbo Mem. Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.      County: Knott
City or Town:  Lackey
Full Name:  Ida COX
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of:  Paris COX
Age of husband or wife if alive:  71 years
Birth date of deceased:  06 June 1874
Age: 68 years, 06 months, 09 days
Birthplace:  Floyd Co., Ky.
Occupation:  Domestic
Industry or business: (blank)
Father Name:  Jack BROWN
Father Birthplace:  Floyd Co., Ky.
Mother Maiden Name:  Sally BROWN
Mother Birthplace:  Floyd Co., Ky.
Informant:  Paris COX, Lackey, Ky.
Burial Place:  Lackey, Ky.
Date:  17 December 1942
Signature of funeral director: G. D. Ryan, Martin, Ky.
Date received by local registrar:  01 February 1943
Registrar's Signature:  Ida Livingston
Date of Death:  15 December 1942
I hereby certify that I attended deceased from 12 December 1942 to 15 December 1942, that I last saw her alive on 15 December 1942, and that death occurred on the date stated above at 9 a.m.
Immediate cause of death: Myocarditis
Duration: (blank)
Due to: Rheumatic Heart disease
Other Conditions:  Malnutrition
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: N. R. Chitwood, M.D., Lackey, Ky.
Date signed:  29 January 1943
Transcribed by Debbie Tamborski, 17 October 2010