Date:  21 August 1956
Cert: # 56-27255
Place of Death: County: Knott      City or Town: Dema - Rural
Length of stay (in this place): (blank)
Full Name of Hospital or Institution:  (blank)
Usual Residence of Deceased: State: Ky.     County: Knott
City or Town: Dema                 Residence on a Farm?:   Yes
Street Address: (blank)     Residence inside City Limits?:  No
Full Name:    Maggie MARTIN
Date of Death:  21 August 1956 
Sex, Color or Race, Marital Status:  Female, White, Widow
Date of Birth:   01 July 1879
Age:  77 years
Usual Occupation:  (blank)
Kind of Industry or business: (blank)
Birthplace:  Ky. 
Father's Name:  Richard VANCE  
Mother's Maiden Name:  Sarah PIGMAN
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant:   Berlin MARTIN
Disease or condition directly leading to death:  Cardio vascular
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: (blank)
I hereby certify that I attended deceased from 01 August 1956 to 21 August 1956, that I last saw the deceased alive on 10 August 1956, and that death occurred at (blank), from the causes and on the date stated above.
Date signed:   27 December 1956
Address:  Wayland, Ky. 
Signature:  M. V. Wicker, M.D. 
Burial, Cremation or Removal: Burial
Date:   24 August 1956
Name of Cemetery or Crematory:  Whitt Martin
Location:   Dema, Ky.
Date received by local registrar:   07 January 1957
Registrar's Signature: Myrtle Slone
Funeral director & address:   Hall Bros., Martin, Ky.
Transcribed by Debbie Tamborski, 25 April 2012