Date:   18 June 1956
Cert: #56-12605
Place of Death: County: Knott      City or Town:  Kite (Rural)
Length of stay (in this place): (blank)
Street Address or Location:  Kite, Ky.
Usual Residence of Deceased: State: Ky.    County:  Floyd
City or Town: Wayland, Ky.  Street Address:  (blank)
Full Name: Charlie FULTZ 
Date of Death:  18 June 1956 
Sex, Color or Race, Marital Status:  Male, White, Married
Date of Birth:  13 June 1903 
Age: 53 years
Usual Occupation:  Miner
Kind of Industry or business: Coal
Birthplace:   Ky.
Father's Name:  Walker FULTZ 
Mother's Maiden Name:   Martha FULTZ
Was deceased ever in armed forces: No
Social Security No.:  XXX-XX-XXXX
Informant:   Charles WIGGINS
Disease or condition directly leading to death:  Possible Coronary occlusion.  Found dead digging ground hog out of hole.
Interval between onset and death:  ? (transcribed as written)
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 18 June 1956 to 18 June 1956, that I last saw the deceased alive on 18 June 1956, and that death occurred at about 1 p.m., from the causes and on the date stated above.
Date signed:    21 June 1956
Address:  Wheelwright, Ky.
Signature:   J. W. Bailey, M.D.
Burial, Cremation or Removal: Burial
Date:   22 June 1956
Name of Cemetery or Crematory:   Family Cem.
Location:   Morehead, Ky.
Date received by local registrar:   22 June 1956
Registrar's Signature: Myrtle Slone
Funeral director & address:   Turner & Ryan Funeral Home by Roger Turner
Transcribed by Debbie Tamborski, 26 March 2012