Date:   04 October 1941
Cert:   29456 
Place of Death: County: Knott     City or Town: Lackey
Name of Hospital or Institution: Stumbo Memorial Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.      County: Knott Co.
City or Town:  Topmost, Ky.
Full Name:  Martha HICKS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status:  Female, White, Married
Husband or Wife of:  Hershall HICKS
Age of husband or wife if alive:  38 years
Birth date of deceased:  09 July 1911
Age: 30 years, 02 months, 25 days
Birthplace:  Floyd Co, Ky.
Occupation:  Domestic
Industry or business: (blank)
Father Name:  Wilburn OSBORNE
Father Birthplace:  Pike Co., Ky.
Mother Maiden Name:  Etta COOK
Mother Birthplace:  Knott Co., Ky.
Informant:  Wilburn OSBORNE, Bevinsville, Ky.
Burial Place:  Bevinsville, Ky.
Date:   06 October 1941
Signature of funeral director:  O. T. Lemaster, Martin, Ky.
Date received by local registrar:  (blank)
Registrar's Signature:  (blank)
Date of Death:  04 October 1941
I hereby certify that I attended deceased from 03 October 1941 to 04 October 1941, that I last saw her alive on 04 October 1941, and that death occurred on the date stated above at 11:00 a.m.
Immediate cause of death:  Cardiac thrombosis
Duration: mos.
Due to: puerperal sepsis, thrombophlebitis, l. leg
Duration:  02 wks.
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address:  C. R. Messer, M.D., Lackey, Ky.
Date signed:  (blank)
Transcribed by Debbie Tamborski, 12 October 2010