Date:    25 January 1946
Cert:    09427 
Place of Death: County: Knott   City or Town: Lackey
Name of Hospital or Institution: Stumbo Mem. Hosp.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.     County:  Knott
City or Town:  Mousie 
Full Name:  Edna Fay GIBSON 
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:  21 January 1946 
Age:  04 days
Birthplace:  Mousie, Ky.
Occupation:  (blank) 
Industry or business:  (blank)
Father Name:  Samuel GIBSON 
Father Birthplace:  Knott Co. 
Mother Maiden Name:  Rosa SHORT 
Mother Birthplace:   Knott Co., Ky. 
Informant:  Samuel GIBSON, Mousie, Ky. 
Burial Place:   Mousie, Ky. 
Date:  26 January 1946 
Signature of funeral director:  W. J. Ryan, Martin, Ky.
Date received by local registrar: 24 April 1946 
Registrar's Signature: Mrs. Rose B. Craft
Date of Death:  25 January 1946 
I hereby certify that I attended deceased from 25 January 1946 to 25 January 1946, that I last saw him alive on 25 January 1946, and that death occurred on the date stated above at 4:30 p.m.
Immediate cause of death:  Bacillary Dysentery 
Duration: (blank)
Due to:  (blank)
Other Conditions:  None
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work:  (blank)
Means of injury: (blank)
Signature & Address:  A. P. Hodge, M.D., Lackey, Ky.
Date signed:  23 April 1946 
Transcribed by Debbie Tamborski, 07 December 2010