Date: 27 September 1922
Cert: 20785
Place of Death: Voting Precinct: Buck Creek, Owsley Co.,
Ky.
Full Name: Verginia DOOLEY
Sex, Color or Race, Marital Status: Female, White,
Married
Date of Birth: 22 January 1877
Age: 45 years, 08 months, 05 days
Occupation: Housewife
Birthplace: Ky.
Name of Father: Benton CORNETT
Birthplace Father: Ky.
Maiden name of Mother: Margrett COMBS
Birthplace Mother: Ky.
Informant/Address: Bascom DOOLEY, Scoville, Ky.
Filed: 12 October 1922
Registrar: J. O. Isaacs
Death Date:
I hereby certify that I attended deceased from (blank), to
(blank), that I last saw h-- alive on (blank), and that death
occurred, on the date stated above at (blank)
Cause of Death: Heart Failure
Duration: 02 days
Contributory: (blank)
Signed/Address: (blank)
Length of residence at place of death: (blank)
Where was disease contracted if not at place of death?:
(blank)
Place of Burial or Removal: Mainous G. Y.
Date of Burial: 28 September 1922
Undertaker/Address: Bascom Dooley, Scoville, Ky.
Transcribed by Debbie Tamborski, 06 December 2010 |