Date  17 July 1954
Cert:  # 16302
Place of Death: County: Knott
City or Town: Garner
Length of stay in hospital or community: (blank)
Name of Hospital or Institution: 
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town:  Hindman
Full Name: Quillen Gayheart
Date of Death:  17 July 1954
Sex, Color or Race, Marital Status: male, white, widowed
Date of Birth:  27 December 1889
Age: 64
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace:  Knott Co KY
Father's Name: 
Mother's Maiden Name: 
Was deceased in ever in armed forces: (blank)
Social Security No.: (blank)
Informant: 
Disease or condition directly leading to death:  Heart Failure
Interval between onset and death: 
Due to:  Heart Condition of Several Years
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings for operation: (blank)
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 to (blank), that I last saw the deceased alive on , and that death occurred on the date stated above at  from the causes and on the date stated above.
Date signed: 18 July 1954
Address: Hindman, KY
Signature:  John Everage ~ Coroner KC
Burial, Cremation or Removal:  Burial
Date:  19 July 1954
Name of Cemetery or Crematory:  Family Cemetery
Location: Garner, KY
Date received by local registrar: 29 July 1954
Registrar's Signature: Myrtle Slone
Funeral director and address: John Everage ~ Hindman, KY
Transcribed by Gloria Marcum ~ 15 March 2010