Date:  03 December 1956
Cert: #56-25982
Place of Death: County: Knott     City or Town: Cordia - Rural
Length of stay (in this place):  none
Full Name of Hospital or Institution:  (blank)
Usual Residence of Deceased: State: Kentucky   County: Knott
City or Town: Cordia                Residence on a Farm?:   Yes
Street Address: (blank)     Residence inside City Limits?:  No
Full Name:  John Riley KELLY
Date of Death:  03 December 1956 
Sex, Color or Race, Marital Status: Male, White, Widowed 
Date of Birth:  08 December 1878
Age:  78 years
Usual Occupation:  Retired Lumberman
Kind of Industry or business: none
Birthplace:   Lotts Creek, Knott Co., Ky.
Father's Name:    William KELLY
Mother's Maiden Name:   Sally YOUNG
Was deceased ever in armed forces:  No
Social Security No.: (blank)
Informant:   Mrs. M. F. Kelly (Sister-in-law)
Disease/condition directly leading to death:  Cancer of Stomach
Interval between onset and death:  (blank)
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Describe how injury occurred:  (blank)
Time of injury:  (blank)
Injury occurred at work: (blank)
Place of injury: (blank)
City, Town or Location, County, State: Hindman, Knott, Ky.
I hereby certify that I attended deceased from 15 January 1955 to 03 December 1956, that I last saw the deceased alive on 03 December 1956, and that death occurred at 10:50 a.m., from the causes and on the date stated above.
Date signed:   04 December 1956
Address:   Hindman, Ky.
Signature:  M. F. Kelly, M.D.
Burial, Cremation or Removal: Burial
Date:   05 December 1956
Name of Cemetery or Crematory:   Kelly Cemetery
Location:  Lotts Creek, Cordia, Knott Co., Ky.
Date received by local registrar:   07 December 1956
Registrar's Signature: Myrtle Slone
Funeral director & address:  Maggard Funeral Home, Hazard, Kentucky 
Transcribed by Debbie Tamborski, 25 April 2012