Date:  16 January 1956
Cert:  #56-1253
Place of Death: County: Knott      City or Town: Anco - Rural
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky.      County: Knott
City or Town:  Anco - Rural     Street Address: (blank)
Full Name:  David KELLY
Date of Death:  16 January 1956
Sex, Color or Race, Marital Status:  Male, White, Married
Date of Birth:  25 January 1891
Age:  65 years
Usual Occupation:  Farmer
Kind of Industry or business: (blank)
Birthplace:  Ky.
Father's Name:  John KELLY
Mother's Maiden Name:  Sarah HAMMONDS
Was deceased ever in armed forces: No
Social Security No.:  XXX-XX-XXXX
Informant:  Beatrice SMITH
Disease or condition directly leading to death:  Pulmonary Hemorrhage
Interval between onset and death:  02 weeks
Due to (b):  Senility
Due to (c): (illegible)
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 02 January 1956 to 16 January 1956, that I last saw the deceased alive on 15 January 1956, and that death occurred at 10 p.m., from the causes and on the date stated above.
Date signed:   21 January 1956
Address:  Allock, Ky.
Signature:  A. B. Pigman, M.D.
Burial, Cremation or Removal: Burial
Date:  18 January 1956
Name of Cemetery or Crematory:  Kelly Cem.
Location:  Anco, Ky.
Date received by local registrar:  21 January 1956
Registrar's Signature: Myrtle Slone
Funeral director & address:  Neighbors & Friends, Anco
Transcribed by Debbie Tamborski, 25 March 2012