Date:    27 February 1944
Cert:    04916 
Place of Death: County: Knott   City or Town:  Hindman, Ky.
Street Number or Location:  Rural
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.      County:  Knott
City or Town:  Hindman 
Full Name:  Dana Marion GAYHEART 
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status:  Female, White, Single
Husband or Wife of:  (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased:   22 August 1934
Age:  09 years, 06 months, 05 days
Birthplace:  Knott Co., Ky. 
Occupation:  School Girl 
Industry or business: (blank)
Father Name: Millard GAYHEART 
Father Birthplace:  Knott Co., Ky.
Mother Maiden Name:  Mary FUGATE 
Mother Birthplace:  Perry Co., Ky. 
Informant:    (blank) Hindman, Ky.
Burial Place:  Fugate Cem., Dwarf, Ky. 
Date:  28 February 1944 
Signature of funeral director:  (blank)
Date received by local registrar: (blank) 
Registrar's Signature: (blank)
Date of Death:  27 February 1944 
I hereby certify that I attended deceased from 26 February 1944 to 27 February 1944, that I last saw him alive on 27 February 1944, and that death occurred on the date stated above at 1 p.m.
Immediate cause of death:  Uremic poisoning caused by (illegible) 
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:  28 February 1944 
Transcribed by Debbie Tamborski, 12 November 2010