Date:   11 November 1943
Cert:   12234 
Place of Death: County: Knott     City or Town: Fisty, Ky.
Street No. or Location:  Rural
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky   County: Knott
City or Town:  Fisty, Ky.     Rural
Full Name:  Sallie FUGATE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White
Husband or Wife of:  Henley FUGATE
Age of husband or wife if alive:  (blank)
Birth date of deceased:  15 August 1854
Age: 89 years, 02 months, 26 days
Birthplace:  Knott County, Ky.
Occupation:  Housewife
Industry or business: Keeping house
Father Name:  Mr. JOHNSON
Father Birthplace:  Breathitt Co., Ky.
Mother Maiden Name:  no one knows
Mother Birthplace:  (blank)
Informant:  Melda FUGATE, Fisty, Ky.
Burial Place:  Talcum, Ky.
Date:  13 November 1943
Signature of funeral director: Frank Fugate, Fisty, Ky.
Date received by local registrar:  20 May 1944
Registrar's Signature:  (blank)
Date of Death:  11 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: Family say this woman fell and broke blood vessel.  No doctor present -- she died before they could get a physician
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:  J. W. Duke, M.D., Hindman
Date signed:  (illegible) May 1944
Transcribed by Debbie Tamborski, 23 October 2010