Date:    28 March 1945
Cert:    06254 
Place of Death: County: Knott   City or Town: Sassafras
Street Number or Location:  Rural
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.     County:  Knott
City or Town: Rural     If rural give precinct:  Sassafras 
Full Name:   Dicy ADAMS KELLY 
If Veteran Name War: (blank)
Social Security No.:  (blank)
Sex, Color or Race, Marital Status:  Female, White, Married
Husband or Wife of:  Geo. W. KELLEY
Age of husband or wife if alive: 77 years
Birth date of deceased:  07 January 1871 
Age: 74 years, 02 months, 21 days
Birthplace:  Knott Co., Ky. 
Occupation:  Housewife 
Industry or business:  (blank)
Father Name:  Dixon ADAMS 
Father Birthplace:  Letcher Co., Ky. 
Mother Maiden Name:   Tilda FRANCIS 
Mother Birthplace:   Knott Co., Ky. 
Informant:  William KELLY, Hazard, Ky. 
Burial Place:   Kelly Cemetery 
Date:  30 March 1945 
Signature of funeral director:  Maggard Funeral, Hazard, Ky.
Date received by local registrar:   31 March 1945 
Registrar's Signature: Rose B. Craft
Date of Death:  28 March 1945 
I hereby certify that I attended deceased from (blank) to (blank), that I last saw him alive on (blank), and that death occurred on the date stated above at 6 p.m.
Immediate cause of death:  Mitral insufficiency and hypertension 
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:  R. L. Collins, Hazard, Ky.
Date signed:  31 March 1945 
Transcribed by Debbie Tamborski, 29 November 2010