Date: 29 July 1942
Cert: 20630
Place of Death: County: Knott City or
Town: Richie, Ky.
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Richie, Ky.
Full Name: Nancy Hall Ritchie FULLER
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female
Husband or Wife of: Tack FULLER
Age of husband or wife if alive: (blank)
Birth date of deceased: 14 June 1867
Age: 75 years, 01 months, 15 days
Birthplace: Kentucky
Occupation: Housewife
Industry or business: Housekeeper
Father Name: Samuel RICHIE
Father Birthplace: Kentucky
Mother Maiden Name: Chloea HALL
Mother Birthplace: Kentucky
Informant: Sam FULLER, Richie, Ky.
Burial Place: Richie, Ky.
Date: 30 July 1942
Signature of funeral director: Sam Richie, Richie, Ky.
Date received by local registrar: 29 August 1942
Registrar's Signature: Ida Livingston
Date of Death: 29 July 1942
I hereby certify that I attended deceased from 01 June 1942 to
29 July 1942, that I last saw her alive on 29 July 1942, and
that death occurred on the date stated above at 8 p.m.
Immediate cause of death: Chronic Dilatatation of the
heart
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: M. F. Kelley, M.D., Hindman, Ky.
Date signed: 17 August 1942
Transcribed by Debbie Tamborski, 17 October 2010 |